Optimal Duration of Continuous Video-Electroencephalography in Term Infants With Hypoxic-Ischemic Encephalopathy and Therapeutic Hypothermia

Author:

Mahfooz Naeem12,Weinstock Arie1,Afzal Bushra3,Noor Mariam1,Lowy David Vargas3,Farooq Osman1,Finnegan Sarah G.1,Lakshminrusimha Satyan3

Affiliation:

1. Department of Neurology, Division of Pediatric Neurology, Women & Children’s Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA

2. Neurological Institute, Epilepsy Center, Cleveland, OH, USA

3. Division of Neonatology, Department of Pediatrics, Women & Children’s Hospital of New York, State University of New York at Buffalo, Buffalo, NY, USA

Abstract

Continuous video-electroencephalography (EEG) is an important diagnostic and prognostic tool in newborns with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia. The optimal duration of continuous video-EEG during whole-body hypothermia is not known. We conducted a retrospective study of 35 neonates with hypoxic-ischemic encephalopathy undergoing whole-body hypothermia with continuous video-EEG. EEG ictal changes were detected in 9/35 infants (26%). Of these 9 infants, the seizures were initially observed within 30 minutes of EEG monitoring in 6 (67%), within 24 hours in 2 (22%), and during rewarming in 1 infant (11%). No new seizures were detected between 24-72 hours of therapeutic hypothermia. Background suppression was detected in 14 infants (40%) by 24 hours. In neonates with hypoxic-ischemic encephalopathy undergoing therapeutic hypothermia, continuous video-EEG has the highest diagnostic yield within the first 24 hours and during the rewarming phase. In the absence of prior seizures or antiepileptic therapy, limiting continuous video-EEG to these periods in resource-limited settings may reduce cost during therapeutic hypothermia.

Publisher

SAGE Publications

Subject

Neurology (clinical),Pediatrics, Perinatology and Child Health

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