title: Optimal Duration of Continuous Video-Electroencephalography in Term Infants With Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia.
abstract: Continuous video-electroencephalography (EEG) is an important diagnostic and prognostic tool in newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia. The optimal duration of continuous video-EEG during whole-body hypothermia is not known. We conducted a retrospective study of 35 neonates with hypoxic-ischemic encephalopathy undergoing whole-body hypothermia with continuous video-EEG. EEG ictal changes were detected in 9/35 infants (26%). Of these 9 infants, the seizures were initially observed within 30 minutes of EEG monitoring in 6 (67%), within 24 hours in 2 (22%), and during rewarming in 1 infant (11%). No new seizures were detected between 24-72 hours of therapeutic hypothermia. Background suppression was detected in 14 infants (40%) by 24 hours. In neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia, continuous video-EEG has the highest diagnostic yield within the first 24 hours and during the rewarming phase. In the absence of prior seizures or antiepileptic therapy, limiting continuous video-EEG to these periods in resource-limited settings may reduce cost during therapeutic hypothermia.
authors.affiliation: 1 Department of Neurology, Division of Pediatric Neurology, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.|2 Neurological Institute, Epilepsy Center, Cleveland, OH, USA.
authors.forename: Naeem
authors.initials: N
authors.lastname: Mahfooz
authors.affiliation: 1 Department of Neurology, Division of Pediatric Neurology, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Arie
authors.initials: A
authors.lastname: Weinstock
authors.affiliation: 3 Division of Neonatology, Department of Pediatrics, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Bushra
authors.initials: B
authors.lastname: Afzal
authors.affiliation: 1 Department of Neurology, Division of Pediatric Neurology, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Mariam
authors.initials: M
authors.lastname: Noor
authors.affiliation: 3 Division of Neonatology, Department of Pediatrics, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: David Vargas
authors.initials: DV
authors.lastname: Lowy
authors.affiliation: 1 Department of Neurology, Division of Pediatric Neurology, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Osman
authors.initials: O
authors.lastname: Farooq
authors.affiliation: 1 Department of Neurology, Division of Pediatric Neurology, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Sarah G
authors.initials: SG
authors.lastname: Finnegan
authors.affiliation: 3 Division of Neonatology, Department of Pediatrics, Women & Children's Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: Satyan
authors.initials: S
authors.lastname: Lakshminrusimha
mesh_terms: D058256:Brain Waves / Q000502:physiology*; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods*; D005260:Female; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods*; D020925:Hypoxia-Ischemia, Brain / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D007091:Image Processing, Computer-Assisted; D007363:Intensive Care Units, Neonatal; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging / Q000209:etiology; D012720:Severity of Illness Index; D014741:Video Recording
keywords: background suppression; cooling; electroencephalography; hypoxic ischemic encephalopathy; seizures; whole body hypothermia