BACKGROUND: The utility of amplitude-integrated electroencephalography (aEEG) monitoring has been established for patients with neonatal hypoxic-ischemic encephalopathy. OBJECTIVE: To evaluate the role of aEEG in the diagnostic process and treatment of patients with encephalopathy due to inborn errors of metabolism. METHODS: Cases collected through an international registry were divided into 5 groups of metabolic disorders. Common aEEG features were sought for each group. RESULTS: In total, 21/30 (70%) cases had abnormal aEEG background patterns, 18/30 (60%) showed seizure activity. Patients with disorders of energy metabolism, hyperammonemia, and organic/amino acidopathies often showed marked aEEG depression with seizure activity. In contrast, aEEGs of patients with peroxisomal disorders did not show major background abnormalities but seizures were present in 5/6 subjects. We report two features of interest: firstly, two tracings displayed an unusual upward shift of the lower aEEG amplitude margin. Secondly, aEEGs of infants with non-ketotic hyperglycinemia showed a pattern we refer to as 'high-frequency burst-suppression pattern'. CONCLUSIONS: aEEG in patients with inborn errors of metabolism frequently reveals abnormalities and assists clinicians in the clinical assessment, management and monitoring of these patients.
BACKGROUND: The utility of amplitude-integrated electroencephalography (aEEG) monitoring has been established for patients with neonatal hypoxic-ischemicencephalopathy. OBJECTIVE: To evaluate the role of aEEG in the diagnostic process and treatment of patients with encephalopathy due to inborn errors of metabolism. METHODS: Cases collected through an international registry were divided into 5 groups of metabolic disorders. Common aEEG features were sought for each group. RESULTS: In total, 21/30 (70%) cases had abnormal aEEG background patterns, 18/30 (60%) showed seizure activity. Patients with disorders of energy metabolism, hyperammonemia, and organic/amino acidopathies often showed marked aEEGdepression with seizure activity. In contrast, aEEGs of patients with peroxisomal disorders did not show major background abnormalities but seizures were present in 5/6 subjects. We report two features of interest: firstly, two tracings displayed an unusual upward shift of the lower aEEG amplitude margin. Secondly, aEEGs of infants with non-ketotic hyperglycinemia showed a pattern we refer to as 'high-frequency burst-suppression pattern'. CONCLUSIONS:aEEG in patients with inborn errors of metabolism frequently reveals abnormalities and assists clinicians in the clinical assessment, management and monitoring of these patients.
Authors: Karl F Schettler; Beatrice Heineking; Silvia Fernandez-Rodriguez; Angelika Pilger; Nikolaus Alexander Haas Journal: J Pediatr Intensive Care Date: 2016-08-08
Authors: Gabriel Fernando Todeschi Variane; João Paulo Vasques Camargo; Daniela Pereira Rodrigues; Maurício Magalhães; Marcelo Jenné Mimica Journal: Front Pediatr Date: 2022-03-23 Impact factor: 3.418