Seizures and electrical discharges in premature infants

Electro-clinical seizures or electrical discharges are described in fifty premature infants divided in two groups: group A (GA twenty-six to thirty-two weeks) = thirty cases - group B (GA thirty-three to thirty-six wks) = twenty cases. In both groups, electrical discharges were shorter than electro-clinical seizures; during seizures ocular manifestations were frequent; bradycardia occurred only in group A. Discharges were associated with other abnormalities (absence of normal EEG pattern, presence of rolandic positive spikes) more frequently in group B than in group A; they occurred without clinical manifestations or coma in nine cases. After anticonvulsant therapy during EEG recording, disappearance of clinical manifestations was observed in four cases with persistence of electrical discharges. In two cases, complete depression of electric activity occurred, lasting less than fifteen minutes. Relatively favourable outcome (15%) was observed with discharges lasting less than five minutes, and, in six cases out of seven, with presence of normal inter-ictal EEG background. EEG helps in recognition of atypical seizures and in assessment of therapeutic effect and prognosis.