Outcome of neonates with electrographically identified seizures, or at risk of seizures

Bye, Ann; Cunningham, Clare; Chee, Kit Y; Flanagan, Daniel

doi:10.1016/s0887-8994(97)00019-2

Cited by 72 publications

(36 citation statements)

References 23 publications

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“…However, clinical data suggest that etiology is the dominant factor in long term outcome. The incidence of epilepsy following neonatal seizures has been estimated in previous studies and it varies from 17% to 30% [9][10][11][12][13][14] . Since the early manuscript from Monod 15 many other studies concerning the power of neonatal EEG to predict neurological outcome have been developed.…”

Section: Prognostic Value Of Non-reactive Burst Suppression Eeg Pattementioning

confidence: 99%

Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures

Nunes

Giraldes

Pinho

et al. 2005

Arq. Neuro-Psiquiatr.

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-Seizures are the most frequent neurological event in newborns and clinical data suggest that etiology is the dominant factor in long term outcome. However, there are consistent background EEG abnormalities associated to neonatal seizures that are usually related to unfavorable outcome as the burst -suppression pattern. Objective: The objective of this study was to correlate clinical and EEG features associated to long -term outcome of newborns with non -reactive burst -suppression (BS) EEG. Method: Newborns included in the study were selected from our database and had conceptional age (at the time of first EEG) >37 weeks, EEG recordings with non -reactive BS available for review and clinical follow up. Results: 12 newborns met inclusion criteria, 50% had seizures in the first day of life. Seizures became refractory to treatment in all of them. In 50% the etiology of seizures was considered cryptogenic, 33% had inborn errors of metabolism and 17% had clinical history and neuroimage suggestive of hypoxic-ischemic encephalopathy. The follow-up showed that 7/12 infants deceased, 3 during the first year of life, and one in the neonatal period. All the survivors had severe developmental delay and multifocal neurological impairment. 92% developed refractory epilepsy, 58% were latter diagnosed with West syndrome. Conclusion: The non-reactive BS pattern may appear related to many neonatal neurological disorders and is associated with early and refractory neonatal seizures. It is clearly associated with elevated morbidity and mortality and to the development of post-neonatal epilepsy.KEY WORDS: neonatal EEG, neonatal seizures, burst-suppression pattern, neonatal epileptic syndromes.Valor prognóstico do EEG com padrão de surto-supressão não reativo associado a convulsões neonatais precoces RESUMO -Convulsões representam o evento neurológico mais freqüente no período neonatal e a etiologia das crises parece ser o aspecto clínico mais associado ao prognóstico a longo prazo. Entretanto, existem padrões anormais de EEG, que de forma consistente relacionam-se a prognóstico, entre eles o padrão de surto -supressão. Objetivo: Este estudo teve como objetivo correlacionar aspectos clínicos e eletroencefalográficos associados a prognóstico em longo prazo de recém -nascidos (RN) com padrão de surto -supressão não reativo no EEG. Método: Foram selecionados para este estudo RN com EEG neonatal realizado no Laboratório de Neurofisiologia Clínica do Hospital São Lucas da PUCRS e acompanhados na mesma instituição, com idade concepcional superior a 37 semanas (na data do EEG), cujos registros estivessem disponíveis para revisão. Resultados: Foram incluídos 12 RN, 50% apresentaram crises convulsivas a partir do primeiro dia de vida. Em todos as convulsões eram refratárias ao tratamento medicamentoso. Em 50% a etiologia foi considerada criptogênica, 33% apresentavam erros inatos do metabolismo e 17% tinham história clíni-ca e achados de neuroimagem sugestivos de encefalopatia hipóxico -isquêmica. O seguimento clínico demonstrou que...

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Section: Prognostic Value Of Non-reactive Burst Suppression Eeg Pattementioning

confidence: 99%

Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures

Nunes

Giraldes

Pinho

et al. 2005

Arq. Neuro-Psiquiatr.

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“…A major confounding factor in the detection of neonatal seizures is the fact that seizures may not be clinically observable, especially if the patient is prescribed with an anti-epileptic drug (Clancy et al, 1988;Bye et al, 1997).…”

Section: Neonatal Seizure Detectionmentioning

confidence: 99%

Artefact Detection and Removal Algorithms for EEG Diagnostic Systems

O’Regan¹

2018

Preprint

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Type of publicationDoctoral thesis Rights AbstractThe electroencephalogram (EEG) is a medical technology that is used in the monitoring of the brain and in the diagnosis of many neurological illnesses. Although coarse in its precision, the EEG is a non-invasive tool that requires minimal set-up times, and is suitably unobtrusive and mobile to allow continuous monitoring of the patient, either in clinical or domestic environments. Consequently, the EEG is the current tool-of-choice with which to continuously monitor the brain where temporal resolution, ease-of-use and mobility are important.Traditionally, EEG data are examined by a trained clinician who identifies neurological events of interest. However, recent advances in signal processing and machine learning techniques have allowed the automated detection of neurological events for many medical applications. In doing so, the burden of work on the clinician has been significantly reduced, improving the response time to illness, and allowing the relevant medical treatment to be administered within minutes rather than hours.However, as typical EEG signals are of the order of microvolts (µV ), contamination by signals arising from sources other than the brain is frequent. These extra-cerebral sources, known as artefacts, can significantly distort the EEG signal, making its interpretation difficult, and can dramatically disimprove automatic neurological event detection classification performance.This thesis therefore, contributes to the further improvement of automated neurological event detection systems, by identifying some of the major obstacles in deploying these EEG systems in ambulatory and clinical environments so that the EEG technologies can emerge from the laboratory towards real-world settings, where they can have a real-impact on the lives of patients. In this context, the thesis tackles three major problems in EEG monitoring, namely: (i) the problem of head-movement artefacts in ambulatory EEG, (ii) the high numbers of false detections in state-of-the-art, automated, epileptiform activity detection systems and (iii) false detections in state-of-the-art, automated neonatal seizure detection systems. To accomplish this, the thesis employs a wide range of statistical, signal processing and machine learning techniques drawn from mathematics, engineering and computer science.The first body of work outlined in this thesis proposes a system to automatically detect head-movement artefacts in ambulatory EEG and utilises supervised machine learning i classifiers to do so. The resulting head-movement artefact detection system is the first of its kind and offers accurate detection of head-movement artefacts in ambulatory EEG.Subsequently, additional physiological signals, in the form of gyroscopes, are used to detect head-movements and in doing so, bring additional information to the head-movement artefact detection task. A framework for combining EEG and gyroscope signals is then developed, offering improved head-movement artefact detection.The artefact detecti...

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“…Although this may be due to differences in patient populations and methodology of the study of neonatal seizures, it may also be due to the methods of surveillance and documentation of seizures that occurred later in life. The reported incidence of postneonatal epilepsy from NCPP (21) and two recent studies (79,80) ranges from 20 to 28% when neonates of all gestational ages are considered. Scher and colleagues (43) considered gestational age and reported that 17% of premature infants and 30% of near-term infants who experienced seizures went on to develop postneonatal epilepsy (Table 4).…”

Section: Treatmentmentioning

confidence: 99%

“…The findings of more recent studies vary, depending on the characteristics of the populations studied, inclusion criteria, and methodology of data analysis. The occurrence of neurologic impairment ranged from 3 1 to 49%, with the most determining factor being the degree and distribution in the brain (78)(79)(80).…”

Section: Treatmentmentioning

confidence: 99%

Acute and Chronic Effects of Seizures in the Developing Brain: Lessons from Clinical Experience

Mizrahi

1999

Epilepsia

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Summary: Seizures in the neonate are often considered a form of status epilepticus (SE) because they are relatively prolonged, difficult to control with antiepileptic drugs (AEDs), and may be associated with significant morbidity and mortality. Despite their clinical importance, there is still no clear understanding of how seizures may affect the developing brain. Although both basic neuroscience and clinical research have addressed these issues, there are difficulties in the design and analysis of each type of investigation. Animal studies should reflect the human condition, the most relevant studies being those that consider neocortical rather than hippocampal seizures. Clinical investigations should be based on precise, age-specific definitions of seizures of epileptic origin and of SE. Treatment strategies should be standardized with defined rationale and end points. Outcome measures are best when defined and quantifiable. The relative effects of underlying CNS injuries that coexist with the onset of neonatal seizures may be difficult to differentiate from the effects of the seizures themselves or their treatment. Current clinical studies suggest that the overriding factors in determining the outcome of neonates with seizures are the cause, the degree, and the distribution of brain injury at the time of seizure occurrence. However, such studies have limitations and may not yet employ methodology sensitive enough to detect a full range of adverse effects of seizures themselves.

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Outcome of neonates with electrographically identified seizures, or at risk of seizures

Cited by 72 publications

References 23 publications

Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures

Prognostic value of non-reactive burst suppression EEG pattern associated to early neonatal seizures

Artefact Detection and Removal Algorithms for EEG Diagnostic Systems

Acute and Chronic Effects of Seizures in the Developing Brain: Lessons from Clinical Experience

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