Additional value of two-channel amplitude integrated EEG recording in full-term infants with unilateral brain injury.
BACKGROUND
Amplitude integrated electroencephalography (aEEG) is a valuable tool for evaluating neonatal encephalopathy and identifying electrographic seizures.


OBJECTIVE
To compare seizure activity and background pattern (BGP) between one-channel and two-channel aEEG recordings in full-term neonates.


METHODS
The two-channel aEEG recordings (F3-P3; F4-P4) of 34 neonates with seizures were compared with single-channel recordings (P3-P4).


RESULTS
All 34 infants with unilateral (n=14), diffuse (n=18) or without (n=2) brain injury had seizure patterns on one-channel and two-channel recordings, with 18% more seizure patterns detected with two-channel recording. In 79% of infants with unilateral injury more seizures were noted on the ipsilateral side compared to the contralateral side. In 39% of the infants with diffuse brain damage more seizures were found with two-channel recordings. A sensitivity of 65% was found when using the automatic seizure detection algorithm. In 4/14 (29%) infants with unilateral injury a more severely affected BGP was seen on the ipsilateral side compared to the BGP on one-channel recording. In infants with diffuse injury differences in BGP pattern were seen in 6-17% of the infants depending on the system used for scoring.


CONCLUSIONS
Although there were no major differences found between seizure detection with one-channel or two-channel aEEG, in a subgroup of infants with a predominantly unilateral brain lesion, two-channel recording did provide additional information with identification of more seizure patterns on the affected side, sometimes also associated with a difference in BGP. To improve early diagnosis of unilateral lesions and improve seizure detection in these infants, routine use of two-channel recordings is recommended.
van Rooij
Linda G M
LG
Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
de Vries
Linda S
LS
van Huffelen
Alexander C
AC
Toet
Mona C
MC
D000465:Algorithms; D001724:Birth Weight; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D012680:Sensitivity and Specificity; D012815:Signal Processing, Computer-Assisted