Original articleAssessment of Neonatal Electroencephalography (EEG) Background by Conventional and Two Amplitude-Integrated EEG Classification Systems
Section snippets
Methods
The Children's Hospital of Philadelphia's Institutional Review Board approved the design of this study. The study's initial goals were to determine the sensitivity of aEEG in recognizing electrographic seizures present on CEEG, the gold standard for seizure detection,9, 15 and to evaluate the agreement in background assessments among aEEG readers using the 2 different classification systems. A sample size of 125 CEEGs was determined to provide a confidence interval of ± 5% regarding the true
Results
A total of 144 neonatal CEEGs from 140 term or near-term neonates (conceptional age, 34 to 50 weeks) were analyzed. The CEEG duration ranged from 23 to 145 minutes. Details of these CEEGs have been described previously.9, 15 Among these CEEGs, 125 records contained seizures, and 19 did not. In those with seizures, the mean seizure rate was 7 seizures per hour (range, 0.5 to 21 seizures per hour). The CEEGs were read simultaneously by 2 of the authors (R.S. and R.C.), and the interictal
Discussion
CEEG has been used for decades to objectively assess the neurologic status of critically ill neonates and is predictive of high risk for subsequent electrographic seizures.7 CEEG has excellent prognostic value1, 2, 3, 4, 5, 6 and is considered the gold standard for electrographic seizure detection and quantification; however, its limited availability and the technical challenges of long-term EEG monitoring have led to the development of complementary types of cerebral function monitoring. aEEG
References (20)
- et al.
Prognostic value of the electroencephalogram in neonatal asphyxia
Electroencephalogr Clin Neurophysiol
(1982) - et al.
Prognostic value of neonatal discontinuous EEG
Pediatr Neurol
(2002) - et al.
Early serial EEG in hypoxic ischaemic encephalopathy
Clin Neurophysiol
(2001) - et al.
Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: a multicentre randomized trial
Lancet
(2005) - et al.
Characterization of neonatal seizures by conventional EEG and single-channel EEG
Clin Neurophysiol
(2007) - et al.
Combined use of electroencephalogram and magnetic resonance imaging in full-term neonates with acute encephalopathy
Pediatrics
(2001) - et al.
The prognostic value of the EEG in asphyxiated newborns
Acta Neurol Scand
(1995) - et al.
Prognostic value of continuous electroencephalographic recording in full term infants with hypoxic ischaemic encephalopathy
Arch Dis Child
(1994) - et al.
EEG background as predictor of electrographic seizures in high-risk neonates
Epilepsia
(1998) - et al.
Non-expert use of the cerebral function monitor for neonatal seizure detection
Arch Dis Child Fetal Neonatal Ed
(2004)
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The authors have no conflicts of interest to declare.