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[Electrophysiological studies in the follow-up of children with perinatal asphyxia history]
J González de Dios1, M Moya Benavent, V Izura Azanza
1Servicio de Pediatría, Hospital Universitario San Juan, Alicante.
Insights
Routine electroencephalogram (EEG) is not useful for monitoring children with perinatal asphyxia. However, auditory-evoked potential (AEP) effectively screens for hearing loss in these high-risk infants.
Area of Science:
- Neonatal neurology
- Pediatric audiology
- Clinical neurophysiology
Background:
- Perinatal asphyxia is a significant cause of neonatal morbidity.
- Neurological sequelae, including motor disabilities and hearing loss, can arise from hypoxic-ischemic encephalopathy.
- Early identification of sequelae is crucial for timely intervention.
Purpose of the Study:
- To evaluate the utility of electroencephalogram (EEG) and auditory-evoked potential (AEP) in the follow-up of children with perinatal asphyxia.
- To determine the incidence of neurological sequelae in this population.
Main Methods:
- Prospective epidemiological study of term neonates with perinatal asphyxia (November 1991-February 1995).
- Grading of perinatal asphyxia and hypoxic-ischemic encephalopathy.
- Neurological assessment and electrophysiological studies (EEG, AEP) at 12-18 months of age.
Main Results:
- 156 cases of perinatal asphyxia identified (31 severe, 125 non-severe).
- Neurological sequelae incidence was 16.5% in followed infants, primarily motor disabilities.
- EEG abnormalities were rare and not associated with seizures; AEP detected clinically unapparent neurosensorial hearing loss in 4 children.
Conclusions:
- Routine EEG is not beneficial for follow-up in children with perinatal asphyxia history.
- AEP serves as a valuable hearing screening tool for infants at risk of deafness due to perinatal asphyxia.
- AEP identified subclinical hearing impairments, highlighting its importance in this population.
Objectives:
The objective of this study was to analyze the usefulness of electrophysiological studies [electroencephalogram (EEG) and auditory-evoked potential (AEP)] during the follow-up of children with perinatal asphyxia antecedents.
Patients And Methods:
A prospective epidemiological study of perinatal asphyxia in term neonates born at the University Hospital San Juan (Alicante, Spain) between November 1991 and February 1995 was performed. Perinatal asphyxia was graded as non-severe (1 minute Apgar score < or = 6 and/or umbilical artery pH < 7.20, with abnormal fetal heart patterns and/or meconium-stained amniotic fluid and the need for immediate neonatal resuscitation) and severe (1 minute Apgar score < or = 3 and umbilical artery pH < 7.10). The incidence of hypoxic-ischemic encephalopathy (classification of Levene and Sarnat & Sarnat) during the neonatal period and neurological sequelae (classification of Finer and Amiel-Tison) during the follow-up period were studied. Electrophysiological studies (EEG and AEP) were made mainly between 12 and 18 months of life.
Results:
During the study period there were 156 cases of perinatal asphyxia in full-term live births (31 severe and 125 non-severe). Hypoxic-ischemic encephalopathy was present in 25.6% of asphyxiated newborn infants, being mild in 30 cases, moderate in 5 and severe in 5. The incidence of neurological sequelae in 115 asphyxiated newborns followed for 24 month was 16.5%. This included mainly motor disabilities. We did not find any case of epilepsy, but there were 4 children with febrile seizures and one case of benign myoclonic seizures. EEG was performed in 88 cases during follow-up, and only was abnormal in two infants without seizures. AEP was performed in 82 cases during follow-up and hearing loss was detected in 4 children with neurosensorial hypoacusia (3 unilateral and 1 bilateral).
Conclusions:
Rutinary EEG is not useful during follow-up of children with antecedents of perinatal asphyxia. However, AEP is a hearing screening procedure for infants at risk of deafness, such as in perinatal asphyxia, and the cases of neurosensorial hearing loss detected by AEP in our population were clinically unapparent.