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Updated: Jul 13, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Neurodevelopmental outcome in term infants with status epilepticus detected with amplitude-integrated
Linda G M van Rooij1, Linda S de Vries, Setyo Handryastuti
1Department of Neonatology, Wilhelmina Children's Hospital, 3508 AB Utrecht, The Netherlands.
Insights
The background EEG pattern, not duration, predicts neurodevelopmental outcomes in term newborns with status epilepticus (SE). Abnormal patterns before and after SE correlate with poor outcomes, especially in hypoxic-ischemic encephalopathy.
Area of Science:
- Neonatal Neurology
- Clinical Neurophysiology
Background:
- Status epilepticus (SE) in term newborns is a critical neurological event.
- Amplitude-integrated electroencephalography (aEEG) is a valuable tool for detecting SE.
- Predicting neurodevelopmental outcomes in affected infants remains a challenge.
Purpose of the Study:
- To evaluate seizure characteristics and neurodevelopmental outcomes in term newborns with aEEG-detected SE.
- To identify predictors of neurodevelopmental outcome in this vulnerable population.
Main Methods:
- A retrospective study of 56 term infants with aEEG-detected SE over 12.5 years.
- Analysis included SE onset, background EEG patterns (pre- and post-SE), seizure control, and neurodevelopmental follow-up.
- Subgroup analysis for hypoxic-ischemic encephalopathy (HIE) and hemorrhage/stroke.
Main Results:
- The incidence of SE was 18%. 75% of infants had poor neurodevelopmental outcomes.
- Abnormal background EEG patterns before and after SE were strongly correlated with poor outcomes.
- In HIE subgroup, both abnormal background patterns and longer SE duration predicted poor outcomes.
- SE control with antiepileptic drugs did not correlate with neurodevelopmental outcome.
Conclusions:
- The pre- and post-SE background EEG pattern is the primary predictor of neurodevelopmental outcome.
- SE duration is predictive only in infants with HIE.
- Antiepileptic drug control efficacy does not predict long-term neurodevelopmental status.
Objectives:
This study evaluated seizure, patient characteristics, and neurodevelopmental outcome of term newborns with amplitude-integrated electroencephalography-detected status epilepticus.
Methods:
Fifty-six term infants with status epilepticus were identified during a 12.5-year period. The time of onset of status epilepticus, background pattern before and after status epilepticus, success of controlling status epilepticus with antiepileptic drugs, and neurodevelopmental outcome were studied.
Results:
The incidence of status epilepticus in our population was 18%. Forty-two infants (75%) had a poor outcome and 14 were normal at follow-up. When all infants were studied as a single group, we found that not the duration, but the background pattern was correlated with neurodevelopmental outcome. In 50% of the infants with a poor outcome, the background pattern was abnormal before the status epilepticus and in 71% after the status epilepticus. Among infants with a good outcome, background pattern was normal in 14% before and 7% after the status epilepticus. In a subgroup of 48 infants with hypoxic-ischemic encephalopathy, there was a significant difference in background pattern, as well as in duration of the status epilepticus between infants with a poor outcome, compared with those with a good outcome. In 48% of the infants with a poor outcome, the background pattern was abnormal before, and in 75% after the status epilepticus, compared with 25% and 13%, respectively, for those with a good outcome. In 57% of the infants with a hemorrhage or perinatal arterial stroke, the status epilepticus was not controlled with antiepileptic drugs, compared with 21% in infants with hypoxic-ischemic encephalopathy (not significant).
Conclusions:
The background pattern at the onset of status epilepticus was the main predictor of neurodevelopmental outcome. The duration of the status epilepticus was only of predictive value in the infants with hypoxic-ischemic encephalopathy. No association was found between the ability to control status epilepticus and subsequent neurodevelopmental outcome.
