[Polygraphic studies in premature and newborn infants. Conclusions for therapy and prognosis]

The polygraphic methods currently available for the prognostication of high-risk neonates are time-consuming, almost inaccessible to visual analysis and unsuited for clinical practice. A polygraphic method has been devised using a restricted number of standardized evaluation criteria arranged according to optimalization principles with a reduction of observation time to three sleep cycles corresponding to an average of 90 minutes. Using this type of "compact polygraphy", 135 newborn infants were divided into a "simple" and a "complicated" group. Their follow-up over the first year of life showed that abnormal EEG tracings and/or clinical manifestations of epilepsy occurred only in infants classified as "complicated". No seizures occurred in the "simple" group. 40% of the patients with complicated prognostication showed neurological abnormalities vs. 8% in the simple group, confirming the prognostic value of compact polygraphy. Since the risk of developing epilepsy was 20% in newborns with postnatal seizures and complicated prognostication, preventive treatment with antiepileptic drugs is recommended in these infants. On the other hand, newborns with postnatal seizures and simple prognostication can be spared the long-term exposure to barbiturates or other anticonvulsants. From our data it appears that compact polygraphy is clinically feasible and has a higher predictive accuracy than any of other currently available practical prognostication methods.