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Preterm EEG: A Multimodal Neurophysiological Protocol
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Preterm EEG: A Multimodal Neurophysiological Protocol

Published on: February 18, 2012

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Early electrographic seizures, brain injury, and neurodevelopmental risk in the very preterm infant

Zachary A Vesoulis1, Terrie E Inder1, Lianne J Woodward1

  • 1Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri.

Pediatric Research
|December 25, 2013
PubMed

Insights

Seizures in very preterm infants within 3 days of birth are common and linked to brain injury and death. These seizures also negatively impact early language development in children.

Area of Science:

  • Neonatal neurology
  • Neurodevelopmental pediatrics
  • Clinical electroencephalography

Background:

  • Seizures in very preterm (VPT) infants have variable prevalence and associations with brain injury and mortality.
  • The impact of early seizures on neurodevelopment in VPT infants remains poorly understood.
  • This study hypothesized that seizures in the first 72 hours post-birth would correlate with brain injury and neurodevelopmental risks.

Purpose of the Study:

  • To investigate the association between early seizures and radiographic brain injury in VPT infants.
  • To determine the relationship between early seizure burden and neonatal outcomes, including death.
  • To assess the impact of early seizures on neurodevelopmental outcomes at 2 years corrected age.

Main Methods:

  • Amplitude-integrated electroencephalogram (aEEG) monitoring was performed on 95 VPT infants for the first 72 hours after birth.
  • Seizure burden was categorized as high or low and correlated with brain imaging findings (IVH, WMI) and neonatal mortality.
  • Neurodevelopmental outcomes were assessed using the Bayley Scales of Infant Development (Bayley III) at 2 years corrected age in a subgroup of 59 infants.

Main Results:

  • The incidence of seizures within the first 72 hours was 48% in the studied VPT infant cohort.
  • A high seizure burden was significantly associated with increased risks of intraventricular hemorrhage (IVH), white matter injury (WMI), and death.
  • Seizure occurrence on any day within the first 3 days was linked to diminished language performance at 2 years corrected age, independent of social risk factors.

Conclusions:

  • Early-onset seizures in VPT infants are frequent and indicate a higher risk for brain injury (IVH, WMI) and mortality.
  • The presence of seizures in the neonatal period is associated with poorer early language development outcomes.
  • These findings underscore the importance of monitoring and managing seizures in VPT infants for improved neurodevelopmental trajectories.
Abstract

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