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Long-term EEG monitoring in the early premature: developmental and chronobiological aspects
B Van Sweden1, M Koenderink, G Windau
1Dept. of Clinical Neurophysiology, Leiden University Medical Center, The Netherlands.
Insights
Electroencephalogram (EEG) patterns in premature infants are not reliable indicators of pathology. However, the continuity index of EEG background activity reflects maturation and the basic rest-activity cycle (BRAC) rhythm.
Area of Science:
- Neonatal Neurology
- Developmental Neuroscience
- Clinical Neurophysiology
Background:
- Long-term electroencephalogram (EEG) monitoring in neonatal intensive care units (NICUs) uses seizure activity for prognostic criteria.
- The clinical significance of continuous and discontinuous EEG patterns in preterm infants remains unclear.
- Intracerebral hemorrhage (ICH) is a concern in premature infants.
Purpose of the Study:
- To investigate the organization and evolution of EEG background activity in preterm infants.
- To determine if EEG patterns correlate with ultrasound-detected intracerebral hemorrhage.
- To assess the role of EEG continuity as a maturational variable.
Main Methods:
- Quantified EEG data from repeated 24-hour recordings in the first week of life.
- Study included premature infants (conceptional age < 32 weeks).
- Infants were categorized with and without ultrasound evidence of intracerebral hemorrhage.
Main Results:
- The repartition and evolution of EEG background activity were not reliable indicators of pathology.
- The continuity index served as a maturational variable.
- Ultradian fluctuations in the continuity index indicated the basic rest-activity cycle (BRAC) rhythm.
Conclusions:
- EEG background activity organization is not a reliable prognostic parameter for pathology in preterm infants.
- The continuity index is a valuable indicator of maturation in preterm neonates.
- The basic rest-activity cycle (BRAC) rhythm is evident early in preterm infants via EEG continuity fluctuations.
Abstract:
Long-term cassette EEG monitoring in the neonatal intensive care unit has established prognostic criteria regarding the developmental outcome by quantifying seizure activity. The clinical significance of the organization of continuous and discontinuous EEG patterns in the early premature is still an open question. This report presents quantified EEG data from repeated 24 h records during the first week of life in premature infants (conceptional age less than 32 weeks) with and without ultrasound evidence of intracerebral hemorrhage. The repartition and evolution of EEG background activity is not a reliable parameter regarding pathology. The continuity index is rather a maturational variable and its ultradian fluctuation is an early expression of the "basic rest activity cycle" (BRAC) rhythm.