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Published on: September 6, 2017
Amplitude-Integrated EEG Monitoring in Pediatric Intensive Care: Prognostic Value in Meningitis before One Year of
Jonathan Beck1,2, Cecile Grosjean1, Nathalie Bednarek1,2
1Department of Neonatology, Reims University Hospital Alix de Champagne, 51100 Reims, France.
Insights
Amplitude-integrated electroencephalography (aEEG) can predict neurological outcomes in infants with meningitis. This technique detects seizures and is valuable for managing pediatric meningitis.
Area of Science:
- Pediatric Neurology
- Critical Care Medicine
Background:
- Pediatric meningitis presents significant morbidity, with neurological complications posing a major challenge.
- Seizures are a key indicator of meningitis and its complications, necessitating effective monitoring tools.
Purpose of the Study:
- To evaluate the predictive value of amplitude-integrated electroencephalography (aEEG) during the acute phase of meningitis in infants.
- To assess the practicality of using aEEG in pediatric intensive care units (PICUs) for meningitis management.
Main Methods:
- Retrospective analysis of aEEG recordings from 25 infants under one year old hospitalized with meningitis.
- Correlation of aEEG data with clinical information and patient outcomes.
- Evaluation of recording quality and timing of initiation.
Main Results:
- aEEG monitoring was initiated early in most patients (72%) with good overall quality.
- The occurrence of seizures, status epilepticus, and specific background patterns on aEEG were significantly linked to poor neurological outcomes.
- aEEG demonstrated effectiveness in detecting subclinical seizures.
Conclusions:
- Amplitude-integrated electroencephalography (aEEG) shows promise in aiding the management and prognostic assessment of pediatric meningitis.
- The technique is practical, reliable, and facilitates the detection of subclinical seizures with minimal training.
- Combining aEEG with conventional electroencephalography (EEG) is recommended for optimal accuracy.
Abstract:
Pediatric morbidity from meningitis remains considerable. Preventing complications is a major challenge to improve neurological outcome. Seizures may reveal the meningitis itself or some complications of this disease. Amplitude-integrated electroencephalography (aEEG) is gaining interest for the management of patients with acute neurological distress, beyond the neonatal age. This study aimed at evaluating the predictive value of aEEG monitoring during the acute phase in meningitis among a population of infants hospitalized in the pediatric intensive care unit (PICU), and at assessing the practicability of the technique. AEEG records of 25 infants younger than one year of age hospitalized for meningitis were retrospectively analyzed and correlated to clinical data and outcome. Recording was initiated, on average, within the first six hours for n = 18 (72%) patients, and overall quality was considered as good. Occurrence of seizure, of status epilepticus, and the background pattern were significantly associated with unfavorable neurological outcomes. AEEG may help in the management and prognostic assessment of pediatric meningitis. It is an easily achievable, reliable technique, and allows detection of subclinical seizures with minimal training. However, it is important to consider the limitations of aEEG, and combinate it with conventional EEG for the best accuracy.
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