José R Castro Conde1, Itziar Quintero Fuentes2, Candelaria González Campo3, Alejandro Jiménez Sosa4, Beatriz Reyes Millán5, Sergio Hernández Expósito6. 1. Department of Neonatology, Hospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain; Research Group on Nutrition, Growth, and Child Development, Spain(1). Electronic address: jcastro@ull.edu.es. 2. Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, Campus de Guajara s/n, 38071 La Laguna, Universidad de La Laguna, Spain; Research Group on Developmental Neuropsychology, Spain(2). Electronic address: iquifu@ull.edu.es. 3. Department of Neonatology, Hospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain. Electronic address: cgoncame@gobiernodecanarias.org. 4. Research Unit, Hospital Universitario de Canarias, Ofra s/n, 38320 La Laguna, Spain. Electronic address: ajimsos@gobiernodecanarias.org. 5. Department of Neonatology, Hospital Universitario Nuestra Señora de La Candelaria, Carretera del Rosario 145, 38010 S/C Tenerife, Spain. Electronic address: breymil@gobiernodecanarias.org. 6. Department of Clinical Psychology, Psychobiology and Methodology, Faculty of Psychology, Campus de Guajara s/n, 38071 La Laguna, Universidad de La Laguna, Spain; Research Group on Developmental Neuropsychology, Spain(2). Electronic address: sexposit@ull.edu.es.
Abstract
BACKGROUND: To analyze the findings in the background EEG activity of infants who suffered perinatal stroke. METHODS: Eleven neonates born 2009-2014 diagnosed of ischemic stroke by MRI (three of them with multistroke) underwent continuous video-EEG monitoring. Visual and spectral (power spectrum and coherence) analyses of the background EEG was performed in three moments: 1) Onset of EEG recording (prior to initiate seizure treatment), 2) Post-ictal epoch (1-2 h after the last seizure), and 3) one-two days after seizure control. All children aged 2-6 years underwent neurodevelopmental assessment. RESULTS: Discontinuity, asymmetry, asynchrony, transients, and relative power spectrum in δ and θ frequency bands increased significantly (p < 0.05) in the post-ictal epoch with respect to onset of EEG recording. After seizure control, discontinuity, asynchrony, and θ power spectrum no longer had significant differences with those found at onset of EEG recording. Significant differences between the ischemic and unaffected hemispheres were found in transients and in β coherence (p = 0.002; p = 0.001, respectively) exclusively in the post-ictal epoch. Seizure burden and time-to-control ranged 5-38 min and 0.5-40 h respectively. Currently, only one child is affected by spastic monoparesis. The intelligence quotients ranged 96-123. CONCLUSIONS: The background EEG can undergo significant changes in the post-ictal epoch due to the seizure activity triggered by the perinatal stroke. Most of these EEG changes involve all brain activity and not exclusively the ischemic hemisphere. Many of these modifications in the EEG background reverse following the seizure control. Video-EEG monitoring allows accurate/immediate diagnosis and rapid/intensive treatment of the stroke-associated seizures.
BACKGROUND: To analyze the findings in the background EEG activity of infants who suffered perinatal stroke. METHODS: Eleven neonates born 2009-2014 diagnosed of ischemic stroke by MRI (three of them with multistroke) underwent continuous video-EEG monitoring. Visual and spectral (power spectrum and coherence) analyses of the background EEG was performed in three moments: 1) Onset of EEG recording (prior to initiate seizure treatment), 2) Post-ictal epoch (1-2 h after the last seizure), and 3) one-two days after seizure control. All children aged 2-6 years underwent neurodevelopmental assessment. RESULTS: Discontinuity, asymmetry, asynchrony, transients, and relative power spectrum in δ and θ frequency bands increased significantly (p < 0.05) in the post-ictal epoch with respect to onset of EEG recording. After seizure control, discontinuity, asynchrony, and θ power spectrum no longer had significant differences with those found at onset of EEG recording. Significant differences between the ischemic and unaffected hemispheres were found in transients and in β coherence (p = 0.002; p = 0.001, respectively) exclusively in the post-ictal epoch. Seizure burden and time-to-control ranged 5-38 min and 0.5-40 h respectively. Currently, only one child is affected by spastic monoparesis. The intelligence quotients ranged 96-123. CONCLUSIONS: The background EEG can undergo significant changes in the post-ictal epoch due to the seizure activity triggered by the perinatal stroke. Most of these EEG changes involve all brain activity and not exclusively the ischemic hemisphere. Many of these modifications in the EEG background reverse following the seizure control. Video-EEG monitoring allows accurate/immediate diagnosis and rapid/intensive treatment of the stroke-associated seizures.