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Burst suppression electroencephalogram pattern in the newborn: predicting the outcome
Laurie M Douglass1, Joyce Y Wu, N Paul Rosman
1Division of Pediatric Neurology, The Floating Hospital for Children at New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA. ldouglass@lifespan.org
Journal of Child Neurology
|August 15, 2002
Summary
Neonatal burst suppression electroencephalograms (EEGs) often indicate a poor prognosis. However, reactive burst suppression patterns may predict a better outcome, with early EEG improvement also suggesting a more favorable neurologic outlook.
Area of Science:
- Neonatal Neurology
- Neurophysiology
- Pediatric Neurology
Background:
- Neonatal burst suppression electroencephalogram (EEG) patterns are typically associated with severe neurological impairment and poor outcomes.
- The prognostic significance of a reactive burst suppression pattern, which can be modulated by external stimuli, remains controversial in neonates.
Purpose of the Study:
- To retrospectively investigate the functional outcomes of full-term newborns diagnosed with burst suppression EEGs.
- To determine if the reactivity of the burst suppression pattern predicts neurological prognosis in neonates.
Main Methods:
- Retrospective analysis of 22 full-term newborns with burst suppression EEGs.
- Classification into three groups based on initial EEG pattern and subsequent changes.
- Functional outcome assessment via record review and telephone interviews at 3 to 9 years of age.
Main Results:
- Group 1 (n=16) with initially nonreactive EEGs had a dire outcome: 11 deaths, 4 profound impairments, and 1 moderate impairment.
- Group 2 (n=3) with nonreactive EEGs that improved early showed favorable outcomes (walking, talking, special education).
- Group 3 (n=3) with initially reactive EEGs demonstrated the best outcomes (independent walking, sentence-level speech).
Conclusions:
- While nonreactive burst suppression EEGs generally indicate a poor neurologic outcome, early EEG improvement may offer a slightly better prognosis.
- Neonates exhibiting reactive burst suppression patterns during the acute phase of illness appear to have the most favorable long-term functional outcomes.