[Coma in full-term newborn infants following acute fetal distress: electro-clinical evolution]

Twenty full term infants who had birth asphyxia were studied. These infants were in a comatose state for 4 to 15 days and at least 3 EEG recordings were performed during this period. Six infants recovered without sequelae and in 2 cases there were minor abnormalities. In 7 cases there were major deficits (follow-up: 1 to 9 years) and 5 infants died within 15 days. Abnormal movements were observed in all the babies. Thirteen infants had EEG documented seizures (intermittent in 5 cases and status epilepticus in 8 cases). The prognosis was not correlated with the time of onset or duration of the coma, the time of onset or type of abnormal movements, nor with the presence of intermittent or continuous electrographic seizure activity. The initial tracing on the first day is the most significant prognostic factor. On subsequent days, an inactive EEG always indicated a poor prognosis. An improvement in the EEG on the 2nd on the 3rd day may not correlate with a favourable outcome since 3 such cases had a poor outcome. The clinical and EEG findings during therapy and the value of high levels of anticonvulsant therapy are discussed.