Long-Term Video Electroencephalographic Monitoring in <30-Week Gestational Age Infants With High-Grade...

Area of Science:

• Neonatal neurology
• Pediatric epilepsy
• Neurocritical care

Background:

• Current guidelines for neonatal seizures lack robust data.
• Preterm neonates (<30 weeks gestation) with high-grade intraventricular hemorrhage (IVH) are at high risk for seizures.
• Evaluating asymptomatic preterm infants requires further investigation.

Purpose of the Study:

• To determine the seizure risk in high-risk preterm infants (<30 weeks gestation) with high-grade IVH.
• To investigate seizure occurrence in asymptomatic infants using long-term video electroencephalographic (EEG) monitoring.
• To identify factors associated with seizure detection in this population.

Main Methods:

• Retrospective review of infants <30 weeks gestation admitted between June 2018 and October 2022.
• Inclusion criteria: underwent EEG monitoring without prior clinical seizure concern.
• Data collected: gestational age, IVH grade, EEG timing and duration.

Main Results:

• Six out of 37 (approximately 16%) infants had subclinical seizures detected by EEG.
• Seizure occurrence was significantly associated with younger chronological age at EEG initiation (median 6.5 days vs 9 days).
• Infants with seizures were more likely to undergo repeat EEG monitoring (P=0.0418).

Conclusions:

• Long-term video EEG monitoring identified seizures in approximately 16% of asymptomatic preterm neonates (<30 weeks gestation) with high-grade IVH.
• Younger chronological age at EEG initiation and increased likelihood of remonitoring were associated with seizure detection.
• These findings highlight the utility of EEG in identifying subclinical seizures in high-risk preterm infants.