Electroencephalography of the Newborn: Normal Features

Scher, Mark S.

doi:10.1016/b978-0-7506-7251-1.50006-x

Cited by 23 publications

(35 citation statements)

References 54 publications

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“…In our study most common type of neonatal seizure is subtle type 95 (63.33%) followed by generalized tonic 29 (19.33), multifocal clonic 15 (10%), focal tonic and focal clonic 4 (2.67% each) and myoclonic 3 (2%). Mizrahi and Kellaway, 10 Scher et al, 11 also found subtle type as most common type seizure which is comparable with our study. In our study perinatal asphyxia 80 (53.33%) was most common cause of neonatal seizure followed by metabolic causes 24 (16%), infections 15 (10%), intracranial hemorrhage in 7 (4.66%), meconium aspiration syndrome 5 (3.33%), bronchopneumonia 3 (2.00%), bilirubin encephalopathy and polycythemia each 2 (1.33%) while 12 (8%) cases had undetermined etiology.…”

Section: Discussionsupporting

confidence: 82%

“…[1][2][3] Thus, determination of etiology is critical, because it gives the opportunity to treat and to make a meaningful statement about the prognosis. [3][4][5] Nowadays, NS is defined by video -electroencephalographic monitoring, by clinical observation associated to ictal or interictal electroencephalogram (EEG), by electrographic discharge without associated clinical manifestation or by neonatal polysomnography 4,[6][7][8][9][10][11][12] . However, in clinical practice at the pediatric or neonatal intensive care units (ICU), in developing countries where synchronized video-EEG monitoring is practically nonexistent, clinical observation becomes the key to the diagnosis 3 .…”

Section: Introductionmentioning

confidence: 99%

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Clinicoetiological profile and outcome of neonatal seizures

Sudia

Berwal

Nagaraj

et al. 2015

Int J Contemp Pediatr

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

Clinicoetiological profile and outcome of neonatal seizures

Sudia

Berwal

Nagaraj

et al. 2015

Int J Contemp Pediatr

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“…Its main feature at the EEG level consists of quasiperiodical bursts of bilateral high-voltage slow waves (mainly Ͻ15 Hz) separated by low-voltage or absent activity lasting from a few seconds to minutes (Chatrian, 1990). BS is associated with coma (Brenner, 1985) and generally develops during hypoxia (Silverman, 1975;Brenner, 1985), cardiac arrest (Zaret, 1985;Young, 2000), drug-related intoxications (Brenner, 1985;Weissenborn et al, 1991;Ostermann et al, 2000;De Rubeis and Young, 2001), childhood encephalopathies (Niedermeyer et al, 1999;Scher, 1999), hypothermia (Pagni and Courjon, 1964;Michenfelder and Milde, 1991;Nakashima et al, 1995), etc.…”

Section: Introductionmentioning

confidence: 99%

Hypersensitivity of the Anesthesia-Induced Comatose Brain

Kroeger

Amzica²

2007

J. Neurosci.

188

201

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Increasing levels of anesthesia are thought to produce a progressive loss of brain responsiveness to external stimuli. Here, we present the first report of a state window within anesthesia-induced coma, usually associated with an EEG pattern of burst suppression, during which brain excitability is dramatically increased so that even subliminal stimuli elicit bursts of whole-brain activity. We investigated this phenomenon in vivo using intracellular recordings of both neurons and glia, as well as extracellular calcium and EEG recordings. The results indicate that the bursting activity elicited with mechanical microstimulations, but also with auditory and visual stimuli, is dependent on complex mechanisms, including modulation of excitatory (NMDA) components, gap junction transmission, as well as the extracellular calcium concentration. The occurrence of bursting events is associated with a postburst refractory period that underlies the genesis of the alternating burst-suppression pattern. These findings raise the issue of what burst spontaneity during anesthesia-induced coma means and opens new venues for the handling of comatose patients.

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“…The second problem is that the EEG acquired in intensive care environments is particularly prone to artefact and the reliable identification and removal of artefacts is essential. Finally, the normal EEG pattern of infants between 26 and 30 wk gestation is markedly discontinuous and consists of long periods of quiescence, interspersed with bursts of electrical activity of high voltage and of mixed frequency (1,6). It is therefore important that any automatic approach to EEG analysis be able to estimate the degree of discontinuity in the trace.…”

mentioning

confidence: 99%

Spectral Analysis of Electroencephalography in Premature Newborn Infants: Normal Ranges

et al. 2005

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Continuous EEG monitoring has not been used widely in neonatal intensive care, especially in the care of extremely premature infants, probably in part because of a lack of a reliable quantitative method. The purpose of this study was to quantify the EEG of the very premature infants just after birth by using spectral analysis and to describe the characteristics of the spectral signal when infants were clinically stable. Digital EEG recordings were performed on 53 infants who were Յ30 wk gestation for 75 min each day during the first 4 d after birth. Artefact was rejected manually after visual inspection of trace. The EEG was analyzed by manual measurement of interburst interval and automatically by spectral analysis using Fast Fourier Transformation. Spectral analysis generated the normal ranges of the relative power of the ␦ (0.5-3.5 Hz), (4 -7.5 Hz), ␣ (8 -12.5 Hz), and ␤ (13-30 Hz) frequency bands, spectral edge frequency, and symmetry. The median (range) relative power of the ␦ band increased significantly from 68% (62-76%) on day 1 to 81% (72-89%) on day 4 (p ϭ 0.001). The interburst intervals became progressively shorter between days 1 [14s (10 -25)] and 3 [8s (6 -12)]; there were no significant differences between days 3 and 4. The relative power of the ␦ band seemed to be the most useful and repeatable spectral measurement for continuous long-term monitoring. However, automatic artefact rejection software needs to be developed before continuous quantitative EEG monitoring can be used in the neonatal intensive care environment. The hemodynamic status of extremely premature infants is particularly labile during the first days after birth. Intensive interventions for such infants are intended to maintain an adequate tissue oxygen supply, particularly to the brain. Because clinical management is aimed at preserving cerebral integrity in these infants, it would be helpful to have some form of continuous neuromonitoring to guide clinical interventions. EEG provides a useful, noninvasive technique for monitoring cerebral electrical activity, and advances in digital technology have made it possible to record high-quality EEG even in an electrically noisy intensive care environment and have done away with the necessity of using large amounts of recording paper. However, interpretation of the EEG is generally considered to be highly specialized, and this is at least one reason that continuous EEG monitoring is not used widely in neonatal intensive care.There are three major issues to be considered for the automatic and reliable analysis of the EEG signal of premature infants and for data to be presented in a manner that is useful to clinicians. First, the EEG of these infants consists predominantly of high-amplitude slow waves (1,2). Bell et al. (3) showed that the relative power of slow waves with frequency Ͻ1 Hz might be as high as 90% in infants at 28 wk gestation. A recent study using DC EEG on infants between 34 and 37 wk gestation found that the spontaneous EEG activity of sleeping preterm infants consiste...

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Electroencephalography of the Newborn: Normal Features

Cited by 23 publications

References 54 publications

Clinicoetiological profile and outcome of neonatal seizures

Clinicoetiological profile and outcome of neonatal seizures

Hypersensitivity of the Anesthesia-Induced Comatose Brain

Spectral Analysis of Electroencephalography in Premature Newborn Infants: Normal Ranges

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