Case-Based Modules > Case 19 > Stage 3

You recommend that somatosensory evoked potentials (SSEPs) of the bilateral upper extremities be performed. The technician arrives to perform the test, but notes that there's a significant amount of myogenic artifact. You discuss with the primary team, who agree with administer a dose of rocuronium. As you're not completely sure that the patient doesn't have any awareness, you also recommend that they err on the side of administering a healthy dose of midazolam at the same time.

SSEP waveforms

SSEP waveforms

Somatosensory Evoked Potentials Report

  • SSEPs were obtained in the upper extremities following independent stimulation of bilateral median nerves
  • SSEPs following median nerve stimulation at the wrist were abnormal bilaterally due to absent cortical potentials

With these findings, you're able to counsel the primary team, and the patient's family, that, sadly, she has a poor neurologic prognosis. Specifically, she is unlikely to improve beyond a state of severe disability, staying in a minimally conscious or unresponsive wakeful state.

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