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Early Electroencephalogram to Predict Severity of Injury in Infants With Abusive Traumatic Brain Injury
Natasha A Varughese1, Ali Hasan2, Naomi Cohen3
12Department of Neurology, Division of Pediatric Neurology, UT Southwestern Medical Center, Dallas, TX, USA.
Insights
Electroencephalography (EEG) findings can predict outcomes in abusive head trauma. Background EEG scores correlate with MRI findings and motor function in young children, suggesting it
Area of Science:
- Pediatric Neurology
- Neuroscience
- Forensic Medicine
Background:
- Abusive head trauma (AHT) poses significant risks to young children.
- Predicting outcomes in AHT is crucial for clinical management.
- Electroencephalography (EEG) is a common diagnostic tool in pediatric neurology.
Purpose of the Study:
- To investigate the correlation between electroencephalographic (EEG) findings and clinical outcomes in children with abusive head trauma (AHT).
- To determine if background EEG activity and seizure burden can serve as prognostic markers in AHT.
Main Methods:
- Retrospective chart review of children under 2 years hospitalized with suspected AHT (2015-2021).
- Correlation analysis (Spearman rank) of background EEG scores and seizure burden against MRI scores and neurofunctional outcomes.
- Utilized validated scoring systems for analysis.
Main Results:
- Significant positive correlation found between background EEG scores and MRI scores (ρ=0.338, P=.011).
- Background EEG scores also correlated positively with motor functional outcomes at 1-6 months (ρ=0.332, P=.017) and 7-12 months (ρ=0.386, P=.08).
- Seizure burden showed positive but non-significant correlations with sensory functional scores.
Conclusions:
- Background EEG activity in children with AHT is an early indicator of prognosis.
- Seizure burden's role in AHT outcomes requires further investigation.
- EEG findings may aid in predicting neurological deficits following abusive head trauma.
Abstract:
This study explored the hypothesis that specific electroencephalographic (EEG) findings may correlate with outcomes in children with abusive head trauma. A retrospective chart review was conducted on children <2 years of age who were hospitalized after suspected abusive head trauma between 2015 and 2021. Based on validated scoring systems, a primary analysis was performed to correlate background EEG scores against magnetic resonance imaging (MRI) scores and neurofunctional outcomes. A secondary analysis was performed to correlate seizure burden against MRI and neurofunctional outcomes. Significant positive correlations (Spearman rank) were discovered between background EEG scores and MRI scores (0.338, P = .011) as well as between background EEG scores and motor functional scores at 1-6 months (0.332, P = .017) and 7-12 months (0.386, P = .08). Seizure burden and sensory functional scores showed positive but statistically insignificant correlations. In conclusion, for children with abusive head trauma, background EEG is an early marker of prognosis whereas seizure burden requires additional study.
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