Ictal and interictal electrographic seizure durations in preterm and term neonates
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Updated: Nov 7, 2026

Preterm EEG: A Multimodal Neurophysiological Protocol
Published on: February 18, 2012
M S Scher1, M Y Hamid, D A Steppe
1Developmental Neurophysiology Laboratory, Magee-Womens Hospital, Pittsburgh, PA 15213-3180.
Insights
Full-term neonates experience significantly longer seizure durations than preterm infants. This difference is linked to more developed neuronal networks in full-term infants, impacting both ictal and interictal periods.
Area of Science:
- Neonatal Neurology
- Developmental Neuroscience
- Epileptology
Background:
- Gestational age's impact on neonatal seizure duration is understudied.
- Neonatal seizures differ significantly from adult epilepsy.
- Understanding seizure characteristics is crucial for neonatal care.
Purpose of the Study:
- To investigate the effect of gestational age on neonatal ictal and interictal durations.
- To compare seizure characteristics between full-term and preterm neonates.
- To analyze differences based on specific preterm subgroups.
Main Methods:
- Retrospective analysis of 68 neonates with 644 electrographic seizures.
- Comparison of full-term (FT) vs. preterm (PT) neonates.
- Subgroup analysis of older preterm (OPT) vs. young preterm (YPT) infants.
- Statistical analysis including t-tests, chi-square, and ANOVA.
Main Results:
- Full-term neonates had higher rates of status epilepticus (SE) than preterm infants (33% vs. 9%).
- Mean ictal duration was significantly longer in FT (14.2 min) vs. PT (3.1 min) infants.
- Longer interictal durations were observed in older preterm (OPT) vs. young preterm (YPT) infants.
Conclusions:
- More developed neuronal networks in full-term neonates contribute to longer ictal durations.
- Gestational age significantly influences neonatal seizure duration and characteristics.
- Findings highlight the importance of considering developmental stage in neonatal epilepsy management.
Abstract:
The effect of gestational age on neonatal ictal and interictal durations has not been investigated. Sixty-eight neonates with 644 electrographic seizures were identified retrospectively. Thirty-five full-term (FT) neonates were compared with 33 preterm (PT) neonates. Eighteen older preterm infants (OPT) [> 31 weeks estimated gestational age (EGA)] were also compared with 15 young preterm infants (YPT) of < or = 31 weeks EGA. Ictal/interictal durations were calculated for the total cohort with and without status epilepticus (SE). Statistical analyses were two-tailed t tests, chi-square calculations, and one-way analysis of variance (ANOVA) with Duncan's multiple-range test. Eleven of 35 (33%) FT had SE as compared with 3 of 33 (9%) PT (chi-square = 7.8, p < 0.05). The mean ictal duration was 14.2 min for FT infants as compared with 3.1 min for PT infants (p < 0.01); only borderline differences were noted after those with SE were excluded. Interictal durations were longer for OPT than YPT (p < 0.05). By ANOVA and Duncan's multiple-range tests, group differences included longer mean ictal durations for FT infants as compared with OPT infants (p = 0.06, ANOVA; p < 0.05, Duncan's), and longer mean interictal durations for FT infants versus OPT and OPT versus YPT (p = 0.02, ANOVA; p < 0.05, Duncan's). More developed neuronal networks result in longer ictal durations in FT than in PT neonates, including FT infants with SE.(ABSTRACT TRUNCATED AT 250 WORDS)
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