A pilot study of continuous limited-channel aEEG in term infants with encephalopathy.
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.
Lawrence
Russell
R
Department of Pediatrics, St Louis Children's Hospital, Washington University, St Louis, MO 63110, USA. Lawrence_r@kids.wustl.edu
Mathur
Amit
A
Nguyen The Tich
Sylvie
S
Zempel
John
J
Inder
Terrie
T
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