The prognostic value of amplitude-integrated electroencephalography in neonates with hypoxic-ischemic encephalopathy

Vasiljević, Brankica; Maglajlić-Djukić, Svjetlana; Gojnić, M

doi:10.2298/vsp1206492v

Cited by 13 publications

(22 citation statements)

References 25 publications

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“…In comparison, electroclinical dissociation has been reported to occur up to 28% of neonates with HIE; however this figure was based on aEEG findings in neonates above 32 weeks gestation and its association with anticonvulsant administration was not described. [20] The studies by van Rooij et al [7] and Mercuri et al [8] did not provide information on the dissociation of seizures. Many of the previous studies reported the clinical response to anticonvulsants without any EEG monitoring.…”

Section: Discussionmentioning

confidence: 98%

Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

et al. 2014

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BackgroundStroke is the second most common cause of seizures in term neonates and is associated with abnormal long-term neurodevelopmental outcome in some cases.ObjectiveTo aid diagnosis earlier in the postnatal period, our aim was to describe the characteristic EEG patterns in term neonates with perinatal arterial ischaemic stroke (PAIS) seizures.DesignRetrospective observational study.PatientsNeonates >37 weeks born between 2003 and 2011 in two hospitals.MethodContinuous multichannel video-EEG was used to analyze the background patterns and characteristics of seizures. Each EEG was assessed for continuity, symmetry, characteristic features and sleep cycling; morphology of electrographic seizures was also examined. Each seizure was categorized as electrographic-only or electroclinical; the percentage of seizure events for each seizure type was also summarized.ResultsNine neonates with PAIS seizures and EEG monitoring were identified. While EEG continuity was present in all cases, the background pattern showed suppression over the infarcted side; this was quite marked (>50% amplitude reduction) when the lesion was large. Characteristic unilateral bursts of theta activity with sharp or spike waves intermixed were seen in all cases. Sleep cycling was generally present but was more disturbed over the infarcted side. Seizures demonstrated a characteristic pattern; focal sharp waves/spike-polyspikes were seen at frequency of 1–2 Hz and phase reversal over the central region was common. Electrographic-only seizure events were more frequent compared to electroclinical seizure events (78 vs 22%).ConclusionsFocal electrographic and electroclinical seizures with ipsilateral suppression of the background activity and focal sharp waves are strong indicators of PAIS. Approximately 80% of seizure events were the result of clinically unsuspected seizures in neonates with PAIS. Prolonged and continuous multichannel video-EEG monitoring is advocated for adequate seizure surveillance.

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Section: Discussionmentioning

confidence: 98%

Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

et al. 2014

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“…In infants who continued to have severely abnormal EEG findings, death, spastic quadriplegia, and major developmental delay were observed. 38,39 There have been conflicting reports regarding EEG findings in outcome prediction. 15,16 Studies suggest that EEG can be a useful predictor of outcome in severe HIE injuries, but that it is not a strong predictor of developmental outcome in mild-to-moderate cases.…”

Section: Discussionmentioning

confidence: 99%

Can We Predict Functional Outcome in Neonates with Hypoxic Ischemic Encephalopathy by the Combination of Neuroimaging and Electroencephalography?

Nanavati

Seemaladinne

Regier

et al. 2015

Pediatrics & Neonatology

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Background Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity, and long-term neurological deficits. Despite the availability of neuroimaging and neurophysiological testing, tools for accurate early diagnosis and prediction of developmental outcome are still lacking. The goal of this study was to determine if combined use of magnetic resonance imaging (MRI) and electroencephalography (EEG) findings could support outcome prediction. Methods We retrospectively reviewed records of 17 HIE neonates, classified brain MRI and EEG findings based on severity, and assessed clinical outcome up to 48 months. We determined the relation between MRI/EEG findings and clinical outcome. Results We demonstrated a significant relationship between MRI findings and clinical outcome (Fisher’s exact test, p = 0.017). EEG provided no additional information about the outcome beyond that contained in the MRI score. The statistical model for outcome prediction based on random forests suggested that EEG readings at 24 hours and 72 hours could be important variables for outcome prediction, but this needs to be investigated further. Conclusion Caution should be used when discussing prognosis for neonates with mild-to-moderate HIE based on early MR imaging and EEG findings. A robust, quantitative marker of HIE severity that allows for accurate prediction of long-term outcome, particularly for mild-to-moderate cases, is still needed.

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“…Hypoxic ischemic encephalopathy depending on severity yields the most abnormal results with 66.66% background activity suppression for HIE-III 5 . Recently Vasiljevic B et al confirm that a EEG is simple and accurate bedside diagnostic method for assessing extension of hypoxic-ischemic brain damage and early identification of neonates with perinatal HIE who are at high risk of neurodevelopmental impairment 7 .…”

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confidence: 99%

Predictive Value of Eeg for Neurodevelopmental Outcome in Neonatal Seizures

Verma¹,

Dutt²,

Rajput³

et al. 2013

jemds

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The prognostic value of amplitude-integrated electroencephalography in neonates with hypoxic-ischemic encephalopathy

Abstract: Our results confirm that aEEG is simple and accurate bedside diagnostic method for assessing extension of hypoxic-ischemic brain damage and early identification of neonates with perinatal HIE who are at high risk of neurodevelopmental impairment.

Cited by 13 publications

References 25 publications

Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures

Can We Predict Functional Outcome in Neonates with Hypoxic Ischemic Encephalopathy by the Combination of Neuroimaging and Electroencephalography?

Predictive Value of Eeg for Neurodevelopmental Outcome in Neonatal Seizures

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