Amplitude-integrated electroencephalography for neonatal seizure detection. An electrophysiological point of view.

Arq Neuropsiquiatr

Hospital de Niños Ricardo Gutiérrez, División de Neurología, Ciudad Autónoma de Buenos Aires, Argentina.

Published: February 2019

Seizures in the newborn are associated with high morbidity and mortality, making their detection and treatment critical. Seizure activity in neonates is often clinically obscured, such that detection of seizures is particularly challenging. Amplitude-integrated EEG is a technique for simplified EEG monitoring that has found an increasing clinical application in neonatal intensive care. Its main value lies in the relative simplicity of interpretation, allowing nonspecialist members of the care team to engage in real-time detection of electrographic seizures. Nevertheless, to avoiding misdiagnosing rhythmic artifacts as seizures, it is necessary to recognize the electrophysiological ictal pattern in the conventional EEG trace available in current devices. The aim of this paper is to discuss the electrophysiological basis of the differentiation of epileptic seizures and extracranial artifacts to avoid misdiagnosis with amplitude-integrated EEG devices.

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http://dx.doi.org/10.1590/0004-282X20180150DOI Listing

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  • A systematic review of 19 studies involving 2074 preterm neonates showed that specific aEEG patterns, such as burst suppression and low voltage backgrounds, are linked to poorer outcomes, while normal backgrounds predict better development.
  • Early monitoring of aEEG, particularly within the first week of life, is crucial for accurately assessing the neurodevelopmental prognosis of preterm infants.
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