Amplitude-integrated electroencephalography in full-term newborns without severe hypoxic-ischemic encephalopathy: case series.
OBJECTIVE
To assess the diagnostic value of amplitude-integrated electroencephalography (EEG) in comparison to standard EEG in newborns without severe hypoxic-ischemic encephalopathy who were at risk for seizures.


METHODS
The study included a consecutive series of 18 term newborns without severe hypoxic-ischemic encephalopathy, but with clinical signs suspicious of epileptic seizures, history of loss of social contact, disturbance of muscle tone, hyperirritability, and/or jitteriness. Amplitude-integrated and standard EEG tracings were assessed for background pattern, epileptiform activity, and sleep-wake cycling.


RESULTS
Amplitude-integrated EEG and standard EEG recordings of 15 newborns were suitable for analysis. Only two different background patterns were seen on amplitude-integrated EEG and standard EEG, with the absence of severely abnormal background patterns. Of 15 newborns, epileptiform discharges were present on amplitude-integrated EEG in 3 newborns, and on standard EEG in 6 newborns. Sensitivity of seizures discharges on amplitude-integrated EEG to correspond with epileptiform discharges on standard EEG was 50%; specificity 100%,positive predictive value 100%, and negative predictive value 75%. Of 4 newborns suspected of having sleep myoclonus, amplitude-integrated EEG correctly identified the newborn who had epileptiform activity on standard EEG.


CONCLUSIONS
The diagnostic value of amplitude-integrated EEG monitoring of term newborns without severe hypoxic-ischemic encephalopathy is limited, but could have a role in evaluating presence or absence of epileptiform activity and in differentiating non-epileptic movement from seizures.
Osredkar
Damjan
D
Department of Pediatric Neurology, University Children's Hospital, Ljubljana, Slovenia. damjan.osredkar@kclj.si
Derganc
Metka
M
Paro-Panjan
Darja
D
Neubauer
David
D
D004569:Electroencephalography / Q000379:methods; D004827:Epilepsy / Q000175:diagnosis*; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted