Amplitude-integrated electroencephalography: a tool for monitoring silent seizures in neonates.
The clinical use of amplitude-integrated electroencephalography in the diagnosis of seizures in high-risk newborn infants with suspected central nervous system insult is evaluated with emphasis on silent seizures. Recordings from 93 infants with suspected central nervous system insults over a period of 7 years were retrospectively analyzed for the presence of electrical seizures and for their correlation with clinical events. Thirty infants (32%) had overt clinical seizures; 29 (97%) of these manifested clear seizure patterns in their tracings, and the remaining one infant had a suspected tracing. Eleven infants (12%) had subtle clinical seizures; of these 7 (59%) had clear electrical seizures, 3 (31%) had suspected tracing, and one had a normal tracing. Fifty-two infants (56%) had no clinical events indicative of seizures; of these 8 (15%) had clear electrical seizures, 17 (33%) had suspected tracings, and 27 (52%) had normal tracings. Electroencephalographic seizures are common in sick newborn infants. Amplitude-integrated electroencephalography can provide important information concerning their neurologic status and help to confirm or refute the presence of seizures in clinically suspected cases and detect infants with silent seizures.
Shany
Eilon
E
Department of Neonatology, Soroka University Medical Center, Beer-Sheva, Israel. eshany@bgumail.bgu.ac.il
Khvatskin
Sonia
S
Golan
Agneta
A
Karplus
Michael
M
D001238:Asphyxia Neonatorum / Q000175:diagnosis; D002540:Cerebral Cortex / Q000503:physiopathology; D003936:Diagnosis, Computer-Assisted / Q000295:instrumentation*; D003937:Diagnosis, Differential; D004569:Electroencephalography / Q000295:instrumentation*; D005071:Evoked Potentials / Q000502:physiology; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal; D008297:Male; D008991:Monitoring, Physiologic / Q000295:instrumentation; D011379:Prognosis; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis*; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation*; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000503:physiopathology