Neurophysiologie clinique = Clinical neurophysiology
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We review the principal aspects of EEG and evoked potential (EP) neuromonitoring in the intensive care unit. The electrophysiological methods allow functional assessment of comatose patients and can be used (a) as a help to diagnose the origin of coma, (b) as a means to predict outcome, and (c) for monitoring purposes. The combination of the EEG and long-, middle-, and short-latency EPs allows widespread assessment of the cerebral cortex, the brain-stem, and the spinal cord. ⋯ While the prognostic value of the EEG is markedly hampered by the widespread use of sedative drugs, it has been possible to design efficient systems based on early- and middle-latency multimodality evoked potentials in anoxic and traumatic comas and, more generally, in all comas associated with an increase of the intracranial pressure. Continuous neuromonitoring techniques are currently under development. They have already been proven useful for the early detection and for the prevention of subclinical seizures, transtentorial herniation, vasospasm, and other causes of brain or spinal-cord ischemia.