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Updated: Aug 13, 2026

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy
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Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

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Silent seizures in sick infants in early life. Diagnosis by continuous cerebral function monitoring

L Hellström-Westas, I Rosén, N W Swenningsen

    Acta Paediatrica Scandinavica
    |September 1, 1985
    PubMed

    Insights

    Silent seizures, characterized by electrographic epileptic activity without clinical signs, were observed in 14 neonatal intensive care infants. This highlights potential insufficiency in current anticonvulsant therapies for neonates.

    Area of Science:

    • Neonatal Neurology
    • Clinical Neurophysiology

    Background:

    • Neonatal intensive care units (NICUs) frequently monitor cerebral electric activity in newborns.
    • Cerebral Function Monitor (CFM) is a key technique for assessing brain activity in infants.

    Observation:

    • Electrographic seizure activity was detected in 26 out of 87 infants.
    • A significant subset of 14 infants experienced prolonged "silent seizures" (over one hour).
    • These silent seizures presented as ictal epileptic activity on CFM without observable clinical symptoms or convulsions.

    Findings:

    • Silent seizures occurred unpredictably in relation to clinical status and management.
    • Infants with silent seizures often exhibited only general limpness or flaccidity, masking the underlying seizure activity.
    • The study identified a critical gap where electrographic seizures may be missed due to lack of clinical manifestation.

    Implications:

    • Current anticonvulsant therapies for neonatal seizures may be insufficient.
    • Re-evaluation of treatment strategies for neonatal epilepsy is warranted.
    • The long-term impact of silent seizures on infant neurodevelopment remains uncertain and requires further investigation.

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