Continuous EEG monitoring in the neonatal intensive care unit.

Continuous EEG monitoring provides an opportunity to both accurately identify seizures and monitor the neurologic status of critically ill neonates in the intensive care unit. The incidence of seizures is higher in the neonatal period than at any other time in life. Seizures and abnormalities of EEG background are associated with significant risk of mortality and long-term neurodevelopmental morbidities. In the neonatal population the majority of seizures are not clinically evident and go undetected without EEG monitoring. We review the incidence and risk factors for neonatal seizures, and the utility of continuous EEG monitoring in the neonatal intensive care unit for seizure detection and for analysis of background to allow prognostication. We consider the role of amplitude-integrated EEG in the neonatal population. We consider the utility of continuous EEG for frequently encountered neurologic indications and discuss the outcome data and some new developments in continuous EEG monitoring.

[1]  P. McNamara,et al.  The Impact of Amplitude-Integrated Electroencephalography on NICU Practice , 2012, Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques.

[2]  Taeun Chang,et al.  The American Clinical Neurophysiology Society's Guideline on Continuous Electroencephalography Monitoring in Neonates. , 2011, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[3]  Taeun Chang,et al.  Symptomatic Neonatal Arterial Ischemic Stroke: The International Pediatric Stroke Study , 2011, Pediatrics.

[4]  L. Nagarajan,et al.  Brief Electroencephalography Rhythmic Discharges (BERDs) in the Neonate With Seizures , 2011, Journal of Child Neurology.

[5]  M. Cilio,et al.  Video-EEG monitoring in newborns with hypoxic-ischemic encephalopathy treated with hypothermia , 2011, Neurology.

[6]  S. E. Rose,et al.  Seizures are associated with brain injury severity in a neonatal model of hypoxia–ischemia , 2010, Neuroscience.

[7]  L. D. de Vries,et al.  Effect of Treatment of Subclinical Neonatal Seizures Detected With aEEG: Randomized, Controlled Trial , 2010, Pediatrics.

[8]  G. Holmes The long-term effects of neonatal seizures. , 2009, Clinics in perinatology.

[9]  A. Bos,et al.  The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis , 2009, Acta paediatrica.

[10]  Kevin J. Staley,et al.  Differences in Cortical versus Subcortical GABAergic Signaling: A Candidate Mechanism of Electroclinical Uncoupling of Neonatal Seizures , 2009, Neuron.

[11]  Steven P. Miller,et al.  Clinical Neonatal Seizures are Independently Associated with Outcome in Infants at Risk for Hypoxic-Ischemic Brain Injury. , 2009, The Journal of pediatrics.

[12]  V. Nadkarni,et al.  Electroencephalographic monitoring during hypothermia after pediatric cardiac arrest , 2009, Neurology.

[13]  Terrie E. Inder,et al.  Accuracy of Bedside Electroencephalographic Monitoring in Comparison With Simultaneous Continuous Conventional Electroencephalography for Seizure Detection in Term Infants , 2008, Pediatrics.

[14]  M. Levene,et al.  The TOBY Study. Whole body hypothermia for the treatment of perinatal asphyxial encephalopathy: A randomised controlled trial , 2008, BMC pediatrics.

[15]  C. Copioli,et al.  Neonatal Seizures: Relation of Ictal Video-Electroencephalography (EEG) Findings With Neurodevelopmental Outcome , 2008, Journal of child neurology.

[16]  F. Pisani,et al.  Neonatal status epilepticus vs recurrent neonatal seizures , 2007, Neurology.

[17]  D. Streiner,et al.  Long-term prognosis in children with neonatal seizures , 2007, Neurology.

[18]  G. Solomon,et al.  Apneic seizures: a sign of temporal lobe hemorrhage in full-term neonates. , 2007, Pediatric neurology.

[19]  M. Vecchierini,et al.  Normal EEG of premature infants born between 24 and 30 weeks gestational age: Terminology, definitions and maturation aspects , 2007, Neurophysiologie Clinique/Clinical Neurophysiology.

[20]  Robert R. Clancy,et al.  Characterization of neonatal seizures by conventional EEG and single-channel EEG , 2007, Clinical Neurophysiology.

[21]  J. Meinzen-Derr,et al.  Amplitude-Integrated EEG Is Useful in Predicting Neurodevelopmental Outcome in Full-Term Infants With Hypoxic-Ischemic Encephalopathy: A Meta-Analysis , 2007, Journal of child neurology.

[22]  G B Boylan,et al.  Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures , 2007, Archives of Disease in Childhood Fetal and Neonatal Edition.

[23]  J. Freeman,et al.  The Use of Amplitude-Integrated Electroencephalography: Beware of Its Unintended Consequences , 2007, Pediatrics.

[24]  Jan Claassen,et al.  Frequency and predictors of nonconvulsive seizures during continuous electroencephalographic monitoring in critically ill children. , 2006, Archives of neurology.

[25]  L. D. de Vries,et al.  Amplitude integrated electroencephalography in the full-term newborn. , 2006, Clinics in perinatology.

[26]  J. Norris,et al.  Maternal Risk Factors for Term Neonatal Seizures: Population-Based Study in Colorado, 1989—2003 , 2006, Journal of child neurology.

[27]  G. Troché,et al.  Status epilepticus after discontinuation of induced hypothermia--an incidental association? , 2006, Resuscitation.

[28]  Sean Connolly,et al.  Prediction of Seizures in Asphyxiated Neonates: Correlation With Continuous Video-Electroencephalographic Monitoring , 2006, Pediatrics.

[29]  G. Holmes Effects of seizures on brain development: lessons from the laboratory. , 2005, Pediatric neurology.

[30]  L. D. de Vries,et al.  Role of cerebral function monitoring in the newborn , 2005, Archives of Disease in Childhood - Fetal and Neonatal Edition.

[31]  Kimberlee Gauvreau,et al.  Electroencephalography in neonatal seizures: comparison of a reduced and a full 10/20 montage. , 2005, Pediatric neurology.

[32]  D. Azzopardi,et al.  Selective head cooling with mild systemic hypothermia after neonatal encephalopathy: multicentre randomised trial , 2005, The Lancet.

[33]  A. Gunn,et al.  Rebound Seizures During Rewarming , 2004, Pediatrics.

[34]  G B Boylan,et al.  Non-expert use of the cerebral function monitor for neonatal seizure detection , 2004, Archives of disease in childhood. Fetal and neonatal edition.

[35]  G. Holmes,et al.  Seizure-Induced Changes in Place Cell Physiology: Relationship to Spatial Memory , 2003, The Journal of Neuroscience.

[36]  G. Holmes,et al.  Neonatal seizures: characteristics of EEG ictal activity in preterm and fullterm infants , 2003, Brain and Development.

[37]  M. Scher,et al.  Uncoupling of EEG-clinical neonatal seizures after antiepileptic drug use. , 2003, Pediatric neurology.

[38]  B. Bourgeois,et al.  Prognostic value of neonatal discontinuous EEG. , 2002, Pediatric neurology.

[39]  M. Scher,et al.  Controversies regarding neonatal seizure recognition. , 2002, Epileptic disorders : international epilepsy journal with videotape.

[40]  D B Vigneron,et al.  Seizure-associated brain injury in term newborns with perinatal asphyxia , 2002, Neurology.

[41]  E. Wirrell,et al.  Prolonged Seizures Exacerbate Perinatal Hypoxic-Ischemic Brain Damage , 2001, Pediatric Research.

[42]  C. Peckham,et al.  Meningitis in infancy in England and Wales: follow up at age 5 years , 2001, BMJ : British Medical Journal.

[43]  J. Tyson,et al.  Risk factors for neonatal seizures: a population-based study, Harris County, Texas, 1992-1994. , 2001, American journal of epidemiology.

[44]  G. Holmes,et al.  Reduced Neurogenesis after Neonatal Seizures , 2001, The Journal of Neuroscience.

[45]  F. Reis,et al.  Duration of rhythmic EEG patterns in neonates: new evidence for clinical and prognostic significance of brief rhythmic discharges , 2000, Clinical Neurophysiology.

[46]  R. Guillet,et al.  Electrographic seizures in neonates correlate with poor neurodevelopmental outcome , 2000, Neurology.

[47]  G. Holmes,et al.  Consequences of recurrent seizures during early brain development , 1999, Neuroscience.

[48]  A. David Edwards,et al.  Assessment of Neonatal Encephalopathy by Amplitude-integrated Electroencephalography , 1999, Pediatrics.

[49]  J Burchfiel,et al.  EEG Background as Predictor of Electrographic Seizures in High‐Risk Neonates , 1998, Epilepsia.

[50]  D. Naidoo,et al.  The effects of morphine and midazolam on EEGs in neonates , 1997, Journal of Clinical Neuroscience.

[51]  D. Lanska,et al.  A population-based study of neonatal seizures in Fayette County, Kentucky , 1995, Neurology.

[52]  I. Rosén,et al.  Low risk of seizure recurrence after early withdrawal of antiepileptic treatment in the neonatal period. , 1995, Archives of disease in childhood. Fetal and neonatal edition.

[53]  G. Holmes,et al.  Prognostic value of background patterns in the neonatal EEG. , 1993, Journal of clinical neurophysiology : official publication of the American Electroencephalographic Society.

[54]  M J Painter,et al.  Electrographic seizures in preterm and full-term neonates: clinical correlates, associated brain lesions, and risk for neurologic sequelae. , 1993, Pediatrics.

[55]  J. Hahn,et al.  Prognostic value of EEG in neonatal meningitis: retrospective study of 29 infants. , 1992, Pediatric neurology.

[56]  R. Clancy,et al.  Neurologic outcome after electroencephalographically proven neonatal seizures. , 1991, Pediatrics.

[57]  A. Legido,et al.  Postnatal Epilepsy After EEG‐Confirmed Neonatal Seizures , 1991, Epilepsia.

[58]  J. Volpe,et al.  Perinatal asphyxia: clinical aspects. , 1989, Clinics in perinatology.

[59]  J Connell,et al.  Continuous EEG monitoring of neonatal seizures: diagnostic and prognostic considerations. , 1989, Archives of disease in childhood.

[60]  A. Legido,et al.  Occult Neonatal Seizures , 1988, Epilepsia.

[61]  Eli M. Mizrahi,et al.  Characterization and classification of neonatal seizures , 1987, Neurology.

[62]  A. Legido,et al.  The Exact Ictal and Interictal Duration of Electroencephalographic Neonatal Seizures , 1987, Epilepsia.

[63]  I Rosén,et al.  Silent Seizures in Sick Infants in Early Life , 1985, Acta paediatrica Scandinavica.

[64]  H. Goldberg Neonatal convulsions--a 10 year review. , 1983, Archives of Disease in Childhood.

[65]  A. Wilkinson,et al.  Diagnosis of neonatal seizure by continuous recording and rapid analysis of the electroencephalogram. , 1983, Archives of disease in childhood.

[66]  J M Freeman,et al.  Neonatal seizures. I. Correlation of prenatal and perinatal events with outcomes. , 1982, Pediatrics.

[67]  R. Zetterström,et al.  NEONATAL CONVULSIONS Incidence and Causes in the Stockholm Area , 1979, Acta paediatrica Scandinavica.

[68]  P. Bray,et al.  Significance of seizures in infants weighing less than 2,500 grams. , 1977, Archives of neurology.

[69]  H. Sarnat,et al.  Neonatal encephalopathy following fetal distress. A clinical and electroencephalographic study. , 1976, Archives of neurology.

[70]  Dena Towner,et al.  Antenatal and intrapartum risk factors for seizures in term newborns: a population-based study, California 1998-2002. , 2009, The Journal of pediatrics.

[71]  Surya N. Gupta,et al.  Intracranial hemorrhage in term newborns: management and outcomes. , 2009, Pediatric neurology.

[72]  G. Ronen,et al.  The epidemiology of clinical neonatal seizures in Newfoundland: a population-based study. , 1999, The Journal of pediatrics.

[73]  G. Hobbs,et al.  Neonatal Seizures , 1999, Journal of Perinatology.