Continuous long-term electroencephalography: the gold standard for neonatal seizure diagnosis

Area of Science:

• Neonatal neurology
• Clinical neurophysiology

Background:

• Newborn infants with cerebral dysfunction, including acute brain injury or developmental disorders, frequently experience encephalopathy and seizures.
• Neonatal seizures are often subclinical, and abnormal movements do not always indicate seizures.

Purpose of the Study:

• To highlight the importance of conventional electroencephalography (EEG) monitoring in the care of at-risk newborns.
• To emphasize the role of EEG in identifying prognostically significant patterns and accurately diagnosing seizures and non-seizure events.

Main Methods:

• Utilizing conventional electroencephalography (EEG) monitoring for continuous assessment of brain activity in at-risk neonates.
• Analyzing EEG background patterns and paroxysmal events for diagnostic and prognostic information.

Main Results:

• Conventional EEG monitoring accurately identifies prognostically significant EEG background patterns.
• EEG enables precise diagnosis of neonatal seizures, distinguishing them from non-seizure events.
• EEG monitoring quantifies seizure burden and guides therapeutic interventions.

Conclusions:

• Judicious use of conventional EEG monitoring is essential for optimizing the care of newborns with or at risk for cerebral dysfunction.
• EEG-guided treatment ensures that neonates with confirmed seizures receive appropriate medication, while those without seizures are protected from potentially harmful, unnecessary treatments.