Marie-Coralie Cornet1, Archana Pasupuleti2, Annie Fang3, Fernando Gonzalez3, Thomas Shimotake3, Donna Marie Ferriero4, Hannah Cranley Glass5, Maria Roberta Cilio6. 1. Department of Pediatrics, Universite Catholique de Louvain, Brussels, Belgium. 2. Department of Neurology, University of California San Francisco, California, USA. 3. Department of Pediatrics, University of California San Francisco, California, USA. 4. Departments of Neurology and Pediatrics, University of California San Francisco, California, USA. 5. Departments of Neurology, Pediatrics, and Epidemiology and Biostatistics, University of California San Francisco, California, USA. 6. Departments of Neurology and Pediatrics, University of California San Francisco, California, USA. Roberta.cilio@ucsf.edu.
Abstract
OBJECTIVES: To assess the prognostic significance of an early normal/mildly abnormal conventional EEG (cEEG) on seizure risk in neonates undergoing therapeutic hypothermia. METHODS: We reviewed the video-EEG recordings from a large cohort of neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy from 2008 to 2017 in a single tertiary center. Continuous video-EEG was started as soon as possible (median 8.2 h) and continued throughout hypothermia and rewarming. We studied those neonates with a normal/mildly abnormal EEG during the first 24 h of monitoring. RESULTS: A total of 331 neonates were treated with hypothermia and 323 had cEEG recordings available for review; 99 were excluded because of a moderately/severely abnormal cEEG background and/or seizure during the first 24 h of recording, and an additional eight because of early rewarming. The remaining 216 had a normal/mildly abnormal cEEG in the first 24 h. None of these patients subsequently developed seizures. CONCLUSION: A normal/mildly abnormal cEEG during the first 24 h indicates a very low risk of subsequent seizures. This suggests that cEEG monitoring can be safely discontinued after 24 h if it has remained normal or excessively discontinuous and no seizures are detected, limiting the need for this resource-intensive and expensive tool.
OBJECTIVES: To assess the prognostic significance of an early normal/mildly abnormal conventional EEG (cEEG) on seizure risk in neonates undergoing therapeutic hypothermia. METHODS: We reviewed the video-EEG recordings from a large cohort of neonates treated with therapeutic hypothermia for hypoxic-ischemicencephalopathy from 2008 to 2017 in a single tertiary center. Continuous video-EEG was started as soon as possible (median 8.2 h) and continued throughout hypothermia and rewarming. We studied those neonates with a normal/mildly abnormal EEG during the first 24 h of monitoring. RESULTS: A total of 331 neonates were treated with hypothermia and 323 had cEEG recordings available for review; 99 were excluded because of a moderately/severely abnormal cEEG background and/or seizure during the first 24 h of recording, and an additional eight because of early rewarming. The remaining 216 had a normal/mildly abnormal cEEG in the first 24 h. None of these patients subsequently developed seizures. CONCLUSION: A normal/mildly abnormal cEEG during the first 24 h indicates a very low risk of subsequent seizures. This suggests that cEEG monitoring can be safely discontinued after 24 h if it has remained normal or excessively discontinuous and no seizures are detected, limiting the need for this resource-intensive and expensive tool.
Authors: L Chalak; L Hellstrom-Westas; S Bonifacio; T Tsuchida; V Chock; M El-Dib; An N Massaro; A Garcia-Alix Journal: Semin Fetal Neonatal Med Date: 2021-07-28 Impact factor: 3.726