Neonatal neurologic and electroencephalographic effects of intrauterine cocaine exposure

Thirty-nine infants with intrauterine exposure to cocaine were examined for neurologic and electroencephalographic (EEG) abnormalities. Of the 39 infants, 34 displayed central nervous system irritability, but only two of the infants required sedation. The EEGs were abnormal in 17 of 38 infants during the first week of life; abnormalities were characterized as showing central nervous system irritability. The EEG abnormalities could not be predicted on the basis of clinical neurologic dysfunction or perinatal variables. On follow-up, 9 of the 17 abnormal EEGs remained abnormal during the second week of life. One infant had an abnormal first EEG at 13 days of age. By 3 to 12 months of age, however, 9 of the 10 previously abnormal tracing had normalized and one is pending. These transient clinical and EEG abnormalities may be the result of changes in neurotransmitter availability and function.