Prolonged EEG depression in term and near-term infants with hypoxic ischemic encephalopathy and later development of West syndrome.
OBJECTIVE
This study was performed to clarify the relationship between prolonged depression of electroencephalography (EEG) in term and near-term infants with hypoxic ischemic encephalopathy (HIE) and the later development of West syndrome (WS).


METHODS
We investigated 17 term and near-term infants with HIE. Inclusion criteria were as follows: ≥35 weeks of gestation, clinical signs of HIE, magnetic resonance imaging (MRI) lesions corresponding to HIE, assessment of outcome at >18 months of age, depression of EEG, and serial EEG examinations. The 17 infants were divided into the following two groups: Group A (n = 4) with prolonged EEG depression over 21 days of age, and group B (n = 13) with disappearance of EEG depression by 21 days of age.


RESULTS
WS developed in all four infants in group A, but in only one of 13 infants in group B. WS occurred significantly more frequently in group A than in group B. For the prediction of subsequent development of WS, prolonged EEG depression over 21 days of age showed sensitivity of 0.80 and specificity of 1.0. In both groups, abnormal irregular faster waves with or without EEG depression were seen in 11 infants between 2 and 28 days of age. They had no significant relationship with WS, but were significantly related to an adverse developmental outcome.


CONCLUSIONS
Prolonged depression of EEG over 21 days of age in term or near-term infants with HIE is a valuable predictor of the later development of WS.
Kato
Toru
T
Department of Pediatrics, Okazaki City Hospital, Okazaki, Aichi, Japan. kato-jes@umin.ac.jp
Okumura
Akihisa
A
Hayakawa
Fumio
F
Tsuji
Takeshi
T
Hayashi
Seiji
S
Kubota
Tetsuo
T
Fukasawa
Tatsuya
T
Suzuki
Motomasa
M
Maruyama
Koichi
K
Oshiro
Makoto
M
Hattori
Tetsuo
T
Kidokoro
Hiroyuki
H
Natsume
Jun
J
Hayakawa
Masahiro
M
Watanabe
Kazuyoshi
K
D001921:Brain / Q000503:physiopathology; D004569:Electroencephalography / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D020925:Hypoxia-Ischemia, Brain / Q000175:diagnosis* / Q000503:physiopathology; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D011237:Predictive Value of Tests; D011379:Prognosis; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000503:physiopathology