Risk factors for EEG seizures in neonates treated with hypothermia: a multicenter cohort study.

Publication/Presentation Date

4-8-2014

Abstract

OBJECTIVE: To assess the risk factors for electrographic seizures among neonates treated with therapeutic hypothermia for hypoxic-ischemic encephalopathy (HIE).

METHODS: Three-center observational cohort study of 90 term neonates treated with hypothermia, monitored with continuous video-EEG (cEEG) within the first day of life (median age at onset of recording 9.5 hours, interquartile range 6.3-14.5), and continued for >24 hours (total recording 93.3 hours, interquartile range 80.1-112.8 among survivors). A pediatric electroencephalographer at each site reviewed cEEGs for electrographic seizures and initial EEG background category.

RESULTS: A total of 43 (48%) had electrographic seizures, including 9 (10%) with electrographic status epilepticus. Abnormal initial EEG background classification (excessively discontinuous, depressed and undifferentiated, burst suppression, or extremely low voltage), but not clinical variables (including pH < 6.8, base excess ≤-20, or 10-minute Apgar ≤ 3), was strongly associated with seizures.

CONCLUSIONS: Electrographic seizures are common among neonates with HIE undergoing hypothermia and are difficult to predict based on clinical features. These results justify the recommendation for cEEG monitoring in neonates treated with hypothermia.

Volume

82

Issue

14

First Page

1239

Last Page

1244

ISSN

1526-632X

Disciplines

Medicine and Health Sciences | Pediatrics

PubMedID

24610326

Department(s)

Department of Pediatrics

Document Type

Article

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