Identifying effect modifiers of systemic hydrocortisone treatment initiated 7-14 days after birth in ventilated very preterm infants on long-term outcome: secondary analysis of a randomised controlled trial.

Objective: To explore clinical effect modifiers of systemic hydrocortisone in ventilated very preterm infants for survival and neurodevelopmental outcome at 2 years' corrected age (CA).

Design: Secondary analysis of a randomised placebo-controlled trial.

Setting: Dutch and Belgian neonatal intensive care units.

Effect of systemic hydrocortisone in ventilated preterm infants on parent-reported behavioural outcomes at 2 years' corrected age: follow-up of a randomised clinical trial.

Objective: To report the parent-reported behavioural outcomes of infants included in the Systemic Hydrocortisone To Prevent Bronchopulmonary Dysplasia in preterm infants study at 2 years' corrected age (CA).

Design: Randomised placebo-controlled trial.

Setting: Dutch and Belgian neonatal intensive care units.

Improving Reliability of Monitoring Background EEG Dynamics in Asphyxiated Infants.

The goal of this study is to develop an automated algorithm to quantify background electroencephalography (EEG) dynamics in term neonates with hypoxic ischemic encephalopathy. The recorded EEG signal is adaptively segmented and the segments with low amplitudes are detected. Next, depending on the spatial distribution of the low-amplitude segments, the first part of the algorithm detects (dynamic) interburst intervals (dIBIs) and performs well on the relatively artifact-free EEG periods and well-defined burst-suppression EEG periods.

The Ages and Stages Questionnaire and Neurodevelopmental Impairment in Two-Year-Old Preterm-Born Children.

Objective: To test the ability of the Ages and Stages Questionnaire, Third Edition (ASQ3) to help identify or exclude neurodevelopmental impairment (NDI) in very preterm-born children at the corrected age of two.

Methods: We studied the test results of 224 children, born at <32 postmenstrual weeks, who had scores on ASQ3 and Bayley Scales of Infant and Toddler Development, Third Edition (BSIDIII) and neurological examination at 22-26 months' corrected age. We defined NDI as a score of <70 on the cognitive--or motor composite scale of BSIDIII, or impairment on neurological examination or audiovisual screening.

Holistic approach for automated background EEG assessment in asphyxiated full-term infants.

Objective: To develop an automated algorithm to quantify background EEG abnormalities in full-term neonates with hypoxic ischemic encephalopathy.

Approach: The algorithm classifies 1 h of continuous neonatal EEG (cEEG) into a mild, moderate or severe background abnormality grade. These classes are well established in the literature and a clinical neurophysiologist labeled 272 1 h cEEG epochs selected from 34 neonates.

Introduction of hypothermia for neonates with perinatal asphyxia in the Netherlands and Flanders.

Background: Therapeutic hypothermia was introduced in the Netherlands and Flanders, Belgium, in 2008. Since then, an increasing number of patients has been treated - up to 166 in 2010. Complications and outcome were registered in an online database.

The puzzle of apparent life-threatening events in a healthy newborn.

Apneic neonatal seizures can present as apparent life-threatening events. We report a newborn with unexplained episodes of apnea associated with cyanosis and desaturation, starting on the first day postpartum. Biochemical tests were normal.

Automated EEG inter-burst interval detection in neonates with mild to moderate postasphyxial encephalopathy.

EEG inter-burst interval (IBI) and its evolution is a robust parameter for grading hypoxic encephalopathy and prognostication in newborns with perinatal asphyxia. We present a reliable algorithm for the automatic detection of IBIs. This automated approach is based on adaptive segmentation of EEG, classification of segments and use of temporal profiles to describe the global distribution of EEG activity.

Relationship of EEG sources of neonatal seizures to acute perinatal brain lesions seen on MRI: a pilot study.

Even though it is known that neonatal seizures are associated with acute brain lesions, the relationship of electroencephalographic (EEG) seizures to acute perinatal brain lesions visible on magnetic resonance imaging (MRI) has not been objectively studied. EEG source localization is successfully used for this purpose in adults, but it has not been sufficiently explored in neonates. Therefore, we developed an integrated method for ictal EEG dipole source localization based on a realistic head model to investigate the utility of EEG source imaging in neonates with postasphyxial seizures.

Somatosensory evoked potentials are of additional prognostic value in certain patterns of brain injury in term birth asphyxia.

Objective: (a) To relate MRI patterns of brain injury to somatosensory evoked potentials (SEPs), and (b) to determine the prognostic value of SEPs in addition to continuous EEG monitoring (cEEG) and cerebral imaging, in term asphyxiated newborns.

Methods: Fifty one consecutive neonates were studied. Survivors were followed for at least 2 years.

Technical standards for recording and interpretation of neonatal electroencephalogram in clinical practice.

Neonatal electroencephalogram (EEG), though often perceived as being difficult to record and interpret, is relatively easy to study due to the immature nature of the brain, which expresses only a few well-defined set of patterns. The EEG interpreter needs to be aware of the maturational changes as well as the effect of pathological processes and medication on brain activity. It gives valuable information for the treatment and prognostication in encephalopathic neonates.

Ictal nystagmus in a newborn baby after birth asphyxia.

Ictal nystagmus (IN) is an uncommon phenomenon characterized by rhythmic saccadic eye movements occurring during epileptic seizures. We report a newborn baby with severe birth asphyxia, undergoing long-term video EEG monitoring with electro-oculogram (EOG), who showed irregular IN when eye movements crossed the midline from left to right and vice versa, resulting in large amplitude of the nystagmoid movements. The nystagmus was followed 15 to 29 seconds later by ictal discharges in the occipital regions.