title: Neonatal seizure detection using multichannel display of envelope trend.
abstract: We aimed to determine whether analysis of EEG envelope trend aids bedside detection of neonatal seizures. Five neonatal EEGs with multiple seizures were used to determine optimal trend parameters for seizure detection. Using these parameters, envelope trends were generated on eight additional EEGs, evaluated by experienced and inexperienced users, and compared to traditional EEG interpretation. Seizures were best detected using envelope trend of 2-6 Hz activity over 20-s epochs. Experienced and inexperienced users identified 88% and 55% of prolonged seizures, respectively, 40% and 6% of brief seizures, and 20% and 0% of slowly evolving seizures. All users identified less than two false positives per hour. Thus, an experienced envelope trend user accurately identified longer seizures but did not identify brief or slowly evolving seizures. Less experienced users were less accurate. Trending may be a useful tool for seizure detection in some neonates.
authors.affiliation: Division of Neurology, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA. abend@email.chop.edu
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Abend
authors.forename: Dennis
authors.initials: D
authors.lastname: Dlugos
authors.forename: Susan
authors.initials: S
authors.lastname: Herman
mesh_terms: D001927:Brain Diseases / Q000453:epidemiology; D002540:Cerebral Cortex / Q000503:physiopathology*; D015897:Comorbidity; D003627:Data Interpretation, Statistical; D004569:Electroencephalography / Q000706:statistics & numerical data*; D004827:Epilepsy / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology*; D005189:False Positive Reactions; D006801:Humans; D007231:Infant, Newborn; D007396:Internship and Residency / Q000592:standards; D008991:Monitoring, Physiologic / Q000706:statistics & numerical data; D009482:Neurophysiology / Q000592:standards; D010372:Pediatrics / Q000193:education; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted; D013997:Time Factors