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Electroencephalogram confirmatory rate in neonatal seizures
1Department of Neurology, University of Wisconsin, Madison 53792-5132, USA.
Pediatric Neurology
|February 24, 1999
Summary
Electroencephalogram (EEG) confirmation rates for neonatal seizures vary by gestational age and cause. Premature infants and those with certain conditions like CNS malformations had lower EEG confirmation rates, impacting mortality predictions.
Area of Science:
- Neonatal Neurology
- Clinical Neurophysiology
Background:
- Electroencephalogram (EEG) is crucial for diagnosing seizures in children and adults.
- However, specific EEG confirmation rates in neonates, considering gestational age and etiology, are not well-established.
Purpose of the Study:
- To define gestation- and etiology-specific EEG confirmatory rates in neonates treated for seizures.
- To examine the relationship between EEG findings, gestational age, seizure etiology, and neonatal mortality.
Main Methods:
- Retrospective review of 4,575 neonates admitted to a NICU between 1985-1996.
- Analysis of 352 EEGs from 183 neonates treated for seizures.
- Statistical examination (Student t test) of EEG findings (epileptiform discharges, background abnormalities) against gestation, etiology, and mortality.
Main Results:
- 144 of 183 neonates (79%) had abnormal EEGs, with 60% showing epileptiform discharges.
- EEG confirmation rate increased with gestation (63% at 28 weeks to 77% at term).
- Etiology significantly impacted rates: CNS infection (95%), hypoxic-ischemic encephalopathy (80%), germinal matrix-intraventricular hemorrhage (65%), CNS malformations (65%).
- Higher EEG confirmation rates predicted lower neonatal mortality (19% vs 6%).
Conclusions:
- Gestational age and seizure etiology are significant factors influencing EEG diagnostic accuracy in neonates.
- EEG findings in neonates are predictive of mortality risk.
- EEG is directly confirmatory in 60% and supportive in 17% of neonatal seizure cases.