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BACKGROUND Therapeutic hypothermia (TH) is becoming standard of care in newborns with hypoxic-ischemic encephalopathy (HIE). The prognostic value of the EEG and the incidence of seizures during TH are uncertain. OBJECTIVE To describe evolution of EEG background and incidence of seizures during TH, and to identify EEG patterns predictive for MRI brain injury. METHODS A total of 41 newborns with HIE underwent TH. Continuous video-EEG was performed during hypothermia and rewarming. EEG background and seizures were reported in a standardized manner. Newborns underwent MRI after rewarming. Sensitivity and specificity of EEG background for moderate to severe MRI brain injury was assessed at 6-hour intervals during TH and rewarming. RESULTS EEG background improved in 49%, remained the same in 38%, and worsened in 13%. A normal EEG had a specificity of 100% upon initiation of monitoring and 93% at later time points. Burst suppression and extremely low voltage patterns held the greatest prognostic value only after 24 hours of monitoring, with a specificity of 81% at the beginning of cooling and 100% at later time points. A discontinuous pattern was not associated with adverse outcome in most patients (73%). Electrographic seizures occurred in 34% (14/41), and 10% (4/41) developed status epilepticus. Seizures had a clinical correlate in 57% (8/14) and were subclinical in 43% (6/14). CONCLUSIONS Continuous video-EEG monitoring in newborns with HIE undergoing TH provides prognostic information about early MRI outcome and accurately identifies electrographic seizures, nearly half of which are subclinical.
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
January 2016,
Journal of pediatric neurosciences,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
December 2020,
Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
January 2012,
Paediatrics & child health,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
July 2018,
Paediatrics & child health,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
January 2015,
Jornal de pediatria,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
April 2016,
Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
September 2010,
Archives de pediatrie : organe officiel de la Societe francaise de pediatrie,
K B Nash, and
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H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
June 2017,
Archivos argentinos de pediatria,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
September 2021,
Anales de pediatria,
K B Nash, and
S L Bonifacio, and
H C Glass, and
J E Sullivan, and
A J Barkovich, and
D M Ferriero, and
M R Cilio
July 2022,
Anales de pediatria,
