title: Influence of hypothermia on the prognostic value of early EEG in full-term neonates with hypoxic ischemic encephalopathy.
abstract: OBJECTIVE
  To determine the prognostic value of early electroencephalograms (EEG) in full-term neonates suffering from hypoxic ischemic encephalopathy (HIE) exposed to whole-body hypothermia (cooled group), compared to neonates treated conventionally (control group).
  
  
  METHODS
  The study included all term neonates born at Grenoble Hospital between 2000 and 2006 with symptoms of HIE. The first two EEGs were reviewed retrospectively and classified according to current electrophysiological criteria. In the cooled group, EEGs were recorded with a mean body temperature of 33°C. Neurological outcome was correlated with EEG pattern.
  
  
  RESULTS
  An EEG inactive or paroxysmal pattern was associated with death in 60% of the controls, while all survivors had neurological sequels. In the cooled group, this EEG pattern was only predictive of death in 40% while survivors had normal examination at 1 year of age. Mild abnormalities on the first EEG correlated with a good prognosis in both groups. The second EEG had a high predictive value, particularly in the cooled group. Persistence of inactivity at 3 days after birth was always associated with death.
  
  
  CONCLUSIONS
  After HIE, the first two EEGs are good prognostic indicators, also in the cooled group. Strong discontinuity in the EEG observed on the first hours after hypothermia induction can be associated with a good outcome.
  
  
  CONCLUSIONS
  Early Stage 4 EEGs recorded during the hypothermia may not always indicate a poor prognosis in HIE.
authors.affiliation: Neurophysiology, Grenoble University Hospital, 38043 Grenoble, France. SHamelin@CHU-grenoble.fr
authors.forename: S
authors.initials: S
authors.lastname: Hamelin
authors.forename: N
authors.initials: N
authors.lastname: Delnard
authors.forename: F
authors.initials: F
authors.lastname: Cneude
authors.forename: T
authors.initials: T
authors.lastname: Debillon
authors.forename: L
authors.initials: L
authors.lastname: Vercueil
mesh_terms: D001034:Apgar Score; D001724:Birth Weight / Q000502:physiology; D001831:Body Temperature; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007036:Hypothermia, Induced; D020925:Hypoxia-Ischemia, Brain / Q000503:physiopathology* / Q000517:prevention & control*; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012640:Seizures / Q000209:etiology; D013534:Survival; D016896:Treatment Outcome