脑电图与体感诱发电位在意识障碍患者诊断及预后评估中的应用

Application of Electroencephalography and Somatosensory Evoked Potentials in the Diagnosis and Prognostic Evaluation of Patients with Disorders of Consciousness

摘要: 意识障碍(Disorders of Consciousness, DoC)是指严重脑损伤导致的觉醒与觉知功能受损状态，包括昏迷、植物状态(VS/UWS)和微小意识状态(MCS)。意识障碍一直是神经科学领域的重要研究课题，其诊断与预后评估对临床决策、医疗资源分配及患者家庭支持具有深远意义，这也是临床实践中的难点。传统的行为学量表评估方法存在主观性强、误诊率高的问题，难以满足现代医学对客观、精准诊断的需求。近年来，脑电图(Electroencephalography, EEG)和体感诱发电位(Somatosensory Evoked Potentials, SSEPs)等神经电生理技术因其具备无创性、可重复性、床旁监测便利性及高时间分辨率的优势，逐渐成为意识障碍评估的关键工具。本文旨在系统梳理脑电图与体感诱发电位在意识障碍诊断及预后中的应用现状，分析其优势与局限性，并探讨未来研究方向。

Abstract: Disorders of consciousness (DoC) are clinically defined as pathological states of disrupted arousal and awareness caused by severe brain injury, encompassing coma, vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS). As a pivotal research focus in neuroscience, the diagnostic stratification and prognostic stratification of DoC carry substantial implications for evidence-based clinical management, optimized healthcare resource utilization, and targeted family counseling, while remaining a persistent challenge in clinical practice. Conventional behavioral assessment scales (e.g., CRS-R) are critically limited by inherent subjective limitations and elevated misdiagnosis rates, failing to meet modern medicine’s demand for objective and precise diagnostics. Recent advances in multimodal neuroelectrophysiological monitoring—particularly electroencephalography (EEG) and somatosensory evoked potentials (SSEPs), have emerged as critical tools for consciousness assessment due to their non-invasive nature, reproducibility, bedside monitoring feasibility, and high temporal resolution. This article systematically reviews current applications of EEG and SSEPs in the diagnosis and prognosis of DoC, analyzes their strengths and limitations, and explores future research directions.