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Updated: May 29, 2026
Application of an Amplitude-integrated EEG Monitor (Cerebral Function Monitor) to Neonates
Published on: September 6, 2017
Fast activity during EEG seizures in neonates
Lakshmi Nagarajan1, Soumya Ghosh, Linda Palumbo
1Department of Neurology, Princess Margaret Hospital for Children, Roberts Road, Subiaco, Perth, WA 6008, Australia. lakshmi.nagarajan@health.wa.gov.au
Insights
Ictal fast activity (FA) on neonatal EEG seizures is strongly linked to clinical symptoms but does not impact neurodevelopmental outcomes.
Area of Science:
- Neonatal neurology
- Epileptology
- Clinical neurophysiology
Background:
- Paroxysmal fast activity (FA) is a potential biomarker for epileptic networks.
- Its presence and significance in neonatal scalp video-electroencephalogram (EEG) seizures require further investigation.
Purpose of the Study:
- To explore the occurrence and clinical significance of ictal FA in neonatal EEG seizures.
- To determine the relationship between ictal FA and electroclinical/electrographic seizures, phenobarbitone use, and neurodevelopmental outcomes.
Main Methods:
- Analysis of 159 neonatal EEG seizures from 42 infants.
- Ictal FA was identified using a 30 Hz low-frequency filter.
- Correlation with electroclinical seizures, phenobarbitone, and neurodevelopmental outcomes was assessed.
Main Results:
- Ictal FA was present in 39% of seizures.
- Seizures with ictal FA were significantly more likely to be electroclinical (55%) than electrographic.
- No association was found between ictal FA and phenobarbitone use, neuroimaging, or neurodevelopmental impairment.
Conclusions:
- Ictal FA on neonatal EEG is highly correlated with clinical seizure manifestations.
- The presence of ictal FA does not appear to affect long-term neurodevelopmental outcomes in neonates.
Introduction:
Paroxysmal fast activity (FA) has been proposed as a marker for epileptic networks. We explore the presence and significance of ictal FA on scalp video EEG seizures (EEG Sz) recorded in neonates.
Methodology:
Forty two babies had 159 EEG Szs. The seizures were analysed for ictal FA, using a low frequency filter of 30 Hz. We explored the relationship of ictal FA to the occurrence of electroclinical and electrographic seizures, the use of phenobarbitone and to neurodevelopmental outcomes.
Results:
Ictal FA occurred in 62 (39%) of the 159 EEG Szs. In the 62 seizures with ictal FA, 34 (55%) were electroclinical seizures (ECSz) and 28 (45%) were electrographic (ESz). In the remaining 97 seizures without ictal FA, 27 (28%) were ECSz and 70 (72%) ESz. There was a significant correlation (p=0.0006) between ictal FA and electroclinical seizures. There was no relationship between phenobarbitone and presence of ictal FA. There was no significant difference in the background EEG, neuroimaging abnormalities, neurodevelopmental impairment or post neonatal seizures between those with and without ictal FA.
Conclusions:
Ictal FA is highly correlated to the occurrence of clinical features during an EEG seizure. The presence of ictal FA does not appear to influence neurodevelopmental outcomes.
