title: A pilot study of continuous limited-channel aEEG in term infants with encephalopathy.
abstract: OBJECTIVE
  To evaluate the accuracy, feasibility, and impact of limited-channel amplitude integrated electroencephalogram (aEEG) monitoring in encephalopathic infants.
  
  
  METHODS
  Encephalopathic infants were placed on limited-channel aEEG with a software-based seizure event detector for 72 hours. A 12-hour epoch of conventional EEG-video (cEEG) was simultaneously collected. Infants were randomly assigned to monitoring that was blinded or visible to the clinical team. If a seizure detection event occurred in the visible group, the clinical team interpreted whether the event was a seizure, based on review of the limited-channel aEEG. EEG data were reviewed independently offline.
  
  
  RESULTS
  In more than 68 hours per infant of limited-channel aEEG monitoring, 1116 seizures occurred (>90% clinically silent), with 615 detected by the seizure event detector (55%). Detection improved with increasing duration of seizures (73% >30 seconds, 87% >60 seconds). Bedside physicians were able to accurately use this algorithm to differentiate true seizures from false-positives. The visible group had a 52% reduction in seizure burden (P = .114) compared with the blinded group.
  
  
  CONCLUSIONS
  Monitoring for seizures with limited-channel aEEG can be accurately interpreted, compares favorably with cEEG, and is associated with a trend toward reduced seizure burden.
authors.affiliation: Department of Pediatrics, St Louis Children's Hospital, Washington University, St Louis, MO 63110, USA. Lawrence_r@kids.wustl.edu
authors.forename: Russell
authors.initials: R
authors.lastname: Lawrence
authors.forename: Amit
authors.initials: A
authors.lastname: Mathur
authors.forename: Sylvie
authors.initials: S
authors.lastname: Nguyen The Tich
authors.forename: John
authors.initials: J
authors.lastname: Zempel
authors.forename: Terrie
authors.initials: T
authors.lastname: Inder
mesh_terms: D001927:Brain Diseases / Q000150:complications*; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000150:complications; D007231:Infant, Newborn; D008297:Male; D008991:Monitoring, Physiologic; D010865:Pilot Projects; D012640:Seizures / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012815:Signal Processing, Computer-Assisted