EEG and the newborn

Abstract

Despite the evolution of new technologies for assessing neonatal brain function, electroencephalography (EEG) remains a powerful tool for neurological diagnosis and prognosis in neonates. It is considered the gold standard for distinguishing epileptic seizures from non-epileptic paroxysmal events and for detecting subclinical seizure activity in high-risk babies. In those babies severely ill, EEG is even more efficient as predictive test than the neurological examination. The prognostic value of neonatal EEG has been long recognized in term as well as in preterm infants. Background patterns, more that patterns of ictal discharges, correlate significantly with the long-term outcome. Although most abnormalities on the neonatal EEG are nonspecific, certain patterns can be highly suggestive for diagnosis. Prognostic value can be increased by obtaining early recordings, possibly within the first 48 hr of life, prolonged recordings to include samples of different activity states, and serial EEGs at short intervals to assess rapid changes that are likely to occur in high-risk infants. It is important to distinguish neonatal seizures from neonatal-onset epilepsies and epilepsy syndromes. Both benign and malignant neonatal epilepsy syndromes exist. While benign familial neonatal seizures represents a neonatal syndrome with benign outcome, early myoclonic encephalopathy and Ohtahara syndrome are the earliest form of age-dependent severe epilepsy syndromes. Early myoclonic encephalopathy and Ohtahara syndrome are both characterized by the presence of a burst-suppression EEG pattern. This pattern is usually associated with a poor prognosis and is considered the electroencephalographic correlate of a complete disconnection within the thalamocortical systems. Migrating partial seizures in infancy is a newly recognized epilepsy syndrome whose onset can be in the neonatal period. It is characterized by multifocal intractable seizures associated with psychomotor impairment. No etiology has been found so far. Different drugs currently used in neonatal intensive care unit, especially if in the toxic range, can alter the EEG background. Those effects need to be taken in account in the interpretation of neonatal EEG.

The Effect of Levocarnitine on Dynamics of the Brain Bioelectrical Activity Formation in Term Infants Delivered by Cesarean Section: Open Randomized Study Results

“…Негативное влияние повреждающих факторов перинатального периода отражается на функциональном состоянии головного мозга новорожденных [4,5]. Объек тивная оценка созревания и выявление дисфункции в работе головного мозга возможны с применением инструментальных методов обследования, в частности ЭЭГ периода естественного сна ребенка [12,14]. Для оценки адекватности процессов созревания головного мозга, его регулирующих возможностей разработана типологическая классификация паттернов ЭЭГ сна, включающая 5 типов сна с учетом степени отклонения от характеристик нормального созревания [ Актуальными проблемами остаются как наиболее ранняя объективная диагностика дисфункции головного мозга, так и своевременная медикаментозная коррекция.…”

Monitoring of newborns at high risk for brain injury

“…There are many different clinical situations in which electroencephalogram (EEG) would be indicated. First of all, as it is non-invasive, it should be considered together with neurological examination, in case of concerns about the neonate’s neurological status or the possibility of seizures [ 3 ], especially if specific risk factors are present [ 4 – 7 ]. Neonatal seizures have been classified into subtle, clonic, myoclonic and tonic, based on their clinical characteristics [ 8 ].…”

“…The accurate assessment of the severity of background EEG abnormalities in the first 6 h of life has become one of the criteria to select newborns for therapeutic hypothermia [ 40 ], even if this task is usually accomplished by means of aEEG [ 3 ]. With the spreading in clinical use of therapeutic hypothermia, it has become clear that it determines a slower recovery rate of background EEG activity compared to normothermic condition [ 41 ].…”

Relationships between variance in electroencephalography relative power and developmental status in infants with typical development and at risk for developmental disability: An observational study

“…Electroencephalography (EEG) offers one non-invasive tool with the potential to identify and quantify atypical brain development. While EEG has been used since the early 1900s to diagnose conditions such as sleep and chronic seizure disorders, it has more recently been investigated as a screening tool in the neonatal intensive care unit for high-risk infant populations 3 . The rapidly growing field of infant EEG seeks to uncover specific abnormalities in activity patterns or key features, and whether these are predictive of short-term and long-term risks or outcomes 3 .…”