Early serial EEG in hypoxic ischaemic encephalopathy.
OBJECTIVE
To perform early serial EEGs in infants with hypoxic ischaemic encephalopathy (HIE) and compare the findings with neurodevelopmental outcome.


METHODS
Nine full-term neonates with HIE had simultaneous video-EEG polygraphic studies within 8 h of birth. The EEG was repeated at 12-24 h intervals. All surviving infants had a neurodevelopmental assessment at 1 year.


RESULTS
Two infants had a normal or mildly abnormal EEG within 8 h of birth and neurodevelopmental outcome was normal. Seven infants had severely depressed background activity in the first 8 h of life. In 3 infants the EEG activity recovered within 12-24 h showing continuous activity with no or only minor abnormalities. All these infants had a normal outcome. The remaining 4 infants, who also had an initially inactive recording, subsequently developed severe background abnormalities. At follow-up, two infants had died and the remainder developed major neurological sequelae.


CONCLUSIONS
Early EEG is an excellent prognostic indicator for a favourable outcome if normal within the first 8 h of life and for a poor outcome if the background activity continues to be inactive or grossly abnormal beyond 8-12 h of life. However, an inactive or very depressed EEG within the first 8 h of life can be associated with good outcome if the EEG activity recovers within 12 h.
Pressler
R M
RM
Department of Clinical Neurophysiology, King's College Hospital, Denmark Hill, SE5 9RS, London, UK. ronit.pressler@kcl.ac.uk
Boylan
G B
GB
Morton
M
M
Binnie
C D
CD
Rennie
J M
JM
D000375:Aging; D000701:Analgesics, Opioid / Q000494:pharmacology; D000927:Anticonvulsants / Q000494:pharmacology; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology*; D007231:Infant, Newborn; D008297:Male; D009020:Morphine / Q000494:pharmacology; D009420:Nervous System / Q000254:growth & development; D011379:Prognosis; D011446:Prospective Studies
D000701:Analgesics, Opioid; D000927:Anticonvulsants; D009020:Morphine