Detection of subclinical electroencephalographic seizure patterns with multichannel amplitude-integrated EEG in full-term neonates.
OBJECTIVE
To compare the seizure pattern detection rate of single-channel and multichannel amplitude-integrated EEG (aEEG), using conventional EEG (cEEG) as a gold standard, in full-term neonates with hypoxic-ischemic encephalopathy. The optimal electrode derivation for seizure detection with single-channel aEEG was also investigated.


METHODS
Twelve infants with cEEG seizure patterns (10s) were investigated. cEEG signals were transformed into aEEG signals. Seizure patterns and the number of patients identified with 1 seizure patterns were calculated for single- and multichannel aEEG.


RESULTS
On cEEG, 121 seizure patterns with a mean duration of 58s were identified, 68% of which occurred over the centrotemporal region. The sensitivity of aEEG for the detection of seizure patterns was 30% (C.I.: 0.22-0.38) for single-channel aEEG and 39% (C.I.: 0.31-0.48) for multichannel aEEG. Multichannel aEEG identified all patients with 1 seizure pattern (C.I.: 0.75-1.00), whereas single-channel aEEG (with C4-C3 as the optimal electrode derivation) identified all but one of the patients (C.I.: 0.66-0.99).


CONCLUSIONS
Seizure pattern detection rate is slightly better with multichannel aEEG compared with single-channel (C4-C3) aEEG. Multichannel aEEG identified correctly all patients with 1 seizure pattern in this small selection of patients.


CONCLUSIONS
Single-channel aEEG may detect most patients (in a selected group) with severe neonatal seizures patterns; patient identification can be improved using multichannel recordings.
Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands. Electronic address: mbourez@sein.nl.
Mireille D
MD
Bourez-Swart
Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Linda
L
van Rooij
Micromed Spa, Mogliano Veneto - TV, Italy.
Cristiano
C
Rizzo
Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Linda S
LS
de Vries
Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Mona C
MC
Toet
Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands.
Tineke A
TA
Gebbink
Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands.
Anja G J
AGJ
Ezendam
Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands.
Alexander C
AC
van Huffelen
D004566:Electrodes / Q000592:standards; D004569:Electroencephalography / Q000295:instrumentation* / Q000379:methods* / Q000592:standards; D006801:Humans; D007231:Infant, Newborn; D012640:Seizures / Q000175:diagnosis* / Q000503:physiopathology*