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Electrographic Seizures during the Early Postnatal Period in Preterm Infants
Rhodri O Lloyd1, John M O'Toole2, Elena Pavlidis1
1Neonatal Brain Research Group, Irish Centre for Fetal and Neonatal Translational Research (INFANT), Department of Pediatrics & Child Health, University College Cork, Cork, Ireland; Department of Neonatology, Cork University Maternity Hospital, Wilton, Cork, Ireland.
Insights
Electrographic seizures are infrequent in very preterm infants within the first few days of birth. Continuous multichannel electroencephalography (EEG) monitoring is crucial for accurate detection of these seizures in this vulnerable population.
Area of Science:
- Neonatal neurology
- Clinical neurophysiology
Background:
- Preterm infants, especially those born before 32 weeks gestational age (GA), are at increased risk for neurological complications.
- Electrographic seizures are a significant concern in this population, but their early postnatal frequency and characteristics are not well-defined.
Purpose of the Study:
- To investigate the frequency and characteristics of electrographic seizures in preterm infants during the early postnatal period.
- To quantify seizure burden using electroencephalography (EEG) metrics.
Main Methods:
- A cohort of 120 infants with GA <32 weeks underwent continuous multichannel EEG monitoring for up to 72 hours post-birth.
- Electrographic seizures were identified visually and analyzed.
- Quantitative descriptors including total seizure burden, seizure duration, and maximum seizure burden were calculated.
Main Results:
- Electrographic seizures occurred in 5% (6/120) of infants.
- Median total seizure burden was 40.3 minutes, median seizure duration was 49.6 seconds, and median maximum seizure burden was 10.8 minutes/hour.
- Higher seizure burden was observed in infants with neuroimaging abnormalities.
Conclusions:
- Electrographic seizures are infrequent in the early days of life among very preterm infants.
- Accurate detection of seizures in this population necessitates continuous multichannel EEG monitoring.
Objective:
To investigate the frequency and characteristics of electrographic seizures in preterm infants in the early postnatal period.
Study Design:
Infants <32 weeks gestational age (GA) (n = 120) were enrolled for continuous multichannel electroencephalography (EEG) recording initiated as soon as possible after birth and continued for approximately up to 72 hours of age. Electrographic seizures were identified visually, annotated, and analyzed. Quantitative descriptors of the temporal evolution of seizures, including total seizure burden, seizure duration, and maximum seizure burden, were calculated.
Results:
Median GA was 28.9 weeks (IQR, 26.6-30.3 weeks) and median birth weight was 1125 g (IQR, 848-1440 g). Six infants (5%; 95% CI, 1.9-10.6%) had electrographic seizures. Median total seizure burden, seizure duration, and maximum seizure burden were 40.3 minutes (IQR, 5.0-117.5 minutes), 49.6 seconds (IQR, 43.4-76.6 seconds), and 10.8 minutes/hour (IQR, 1.6-20.2 minutes/hour), respectively. Seizure burden was highest in 2 infants with significant abnormalities on neuroimaging.
Conclusion:
Electrographic seizures are infrequent within the first few days of birth in very preterm infants. Seizures in this population are difficult to detect accurately without continuous multichannel EEG monitoring.