title: Electrographic seizures in preterm infants during the first week of life are associated with cerebral injury.
abstract: The aim of the study was to determine the incidence of electrographic seizure activity in a prospective cohort of preterm infants and relate it to the presence of cerebral injury. Infants born <30-wk gestation received a median 74 h of continuous 2-channel EEG with amplitude-integrated EEG monitoring in the first week of life. Infants were classified in the abnormal outcome group if they died in the neonatal period and/or had grades 3-4 intraventricular hemorrhage and/or moderate or severe abnormalities on cerebral MRI. Seizures were defined as rhythmic spike and/or wave activity lasting at least 10 s on the raw EEG trace. Eleven of 51 infants monitored had electrographic seizures. These infants were more premature had lower birth weights and a greater proportion had abnormal outcomes. In four infants, seizures preceded ultrasound findings of grades 3-4 intraventricular hemorrhage. Three of the four infants with seizures and concurrent physiologic recordings displayed concurrent rises in heart rate and one showed a fall in respiratory rate. In conclusion, electrographic seizures were more likely to occur in the sicker and more premature infants with abnormal outcomes. Seizures detected on continuous amplitude-integrated EEG monitoring with the raw EEG were associated with poor outcome.
authors.affiliation: Departments of Pediatrics, Washington University, St Louis, Missouri 63110, USA. divyenshah@doctors.org.uk
authors.forename: Divyen K
authors.initials: DK
authors.lastname: Shah
authors.forename: John
authors.initials: J
authors.lastname: Zempel
authors.forename: Tony
authors.initials: T
authors.lastname: Barton
authors.forename: Karen
authors.initials: K
authors.lastname: Lukas
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Inder
mesh_terms: D001930:Brain Injuries / Q000150:complications / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D012640:Seizures / Q000209:etiology / Q000503:physiopathology*