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Updated: Aug 27, 2025
Application of an Amplitude-integrated EEG Monitor Cerebral Function Monitor to Neonates
Published on: September 6, 2017
Poor aEEG background recovery after perinatal hypoxic ischemic encephalopathy predicts postneonatal epilepsy by age
Jenna Nyman1, Kirsi Mikkonen2, Marjo Metsäranta3
1Epilepsia Helsinki, Department of Clinical Neurophysiology, Children's Hospital, HUS Diagnostic Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Epilepsia Helsinki, Division of Child Neurology, Children's Hospital and Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Objective:
This study evaluated the accuracy of neonatal amplitude-integrated electroencephalography (aEEG) brain monitoring for predicting development of postneonatal epilepsy after perinatal hypoxic ischemic encephalopathy (HIE).
Methods:
We studied a population-based cohort of 85 consecutive neonates with moderate-to-severe HIE that had aEEG started <12 hours postnatally. We marked electrographic seizures and graded each hour of the aEEG background as inactive, burst-suppression, or continuous without or with sleep cycling. These aEEG parameters were compared to outcome at 4-years age (deceased, epilepsy, cerebral palsy without epilepsy, favorable), which was available for 80 children.
Results:
At group level, total seizure burden (p = 0.003), maximum hourly seizure burden (p = 0.007), and aEEG background recovery (p < 0.001) were all significantly associated with outcome. At individual level six children developed epilepsy, and the most accurate predictors for later epilepsy were inactive aEEG at 24 hours (accuracy 97%, positive predictive value 100%, two false negatives) and inactive aEEG at the onset of seizures (accuracy 97%, sensitivity of 100%, one false positive).
Conclusions:
At individual level aEEG background recovery was a better predictor for later epilepsy than neonatal seizures, although both were associated with epilepsy at group level.
Significance:
Poor aEEG background recovery predicts development of epilepsy after perinatal HIE at individual level.
