title: Three-channel electroencephalogram montage in neonatal seizure detection and quantification.
abstract: We compared three-channel montage with 21-channel neonatal minimal placement montage for the detection of neonatal seizures and quantification of seizure burden. Thirty-five neonatal electroencephalograms were retrospectively and blindly reviewed by two independent readers. Tracings were analyzed in the three-channel montage for seizure number, duration, and quantification of seizure burden before reanalysis with the full 21-channel neonatal minimal placement montage. Seizures were identified using standard definitions of electroencephalographic seizure. Sensitivity, specificity, and interrater reliability were calculated. The sensitivity and specificity of three-channel montage for detecting seizures > 10 seconds were 91% and 100% for reader 1, respectively, and 82% and 96% for reader 2, respectively. The interrater agreement for detection of seizures was excellent (κ = 0.86, 94% percent overall agreement). For quantification of seizure burden, strong, positive correlation existed between assessments by full montage and three-channel montage (for reader 1, r = 0.945, n = 11, P < 0.0001; for reader 2, r = 0.902, n = 11, P < 0.0001), and strong correlation existed between the readers for three-channel montage (r = 0.879, n = 11, P < 0.0001). Despite its limitations, three-channel montage is useful in the detection of neonatal seizures and quantification of seizure burden.
authors.affiliation: Department of Neurology, University of California at San Diego and Rady Children's Hospital, San Diego, California 92123, USA. mrzimbri@gmail.com
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zimbric
authors.forename: Cia M
authors.initials: CM
authors.lastname: Sharpe
authors.forename: Karen C
authors.initials: KC
authors.lastname: Albright
authors.forename: Mark P
authors.initials: MP
authors.lastname: Nespeca
mesh_terms: D017281:Cost of Illness; D003627:Data Interpretation, Statistical; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D015588:Observer Variation; D012640:Seizures / Q000175:diagnosis*