ABSTRACT

There are many risk factors that cause significant neurologic damage in term and preterm infants who need intensive care. For these patients brain injury prevention has become the main goal of modern neonatalogy. Observing brain functions with electroencephalography (EEG) in newborns may be helpful in determining patients who carry increased risk factors for neurologic morbidity. The aim of this study is to compare the results of the synchronous amplitude EEG (aEEG) and conventional EEG (cEEG) in cases with newborn encephalopathy.

Fifty two newborns cases (27 term, 25 preterm) were included to Ege University, Faculty of Medicine Pediatrics Department Neonatal ICU with possible neurological risk, thus, with neonatal encephalopathy, neurologic disturbance, or severe respiratory distress syndrome (RDS). Amplitude EEG was performed for 24-48 hours. Amplitude EEG was assessed by a neonatalogist using Burdjalov scoring system. The results of simultaneously performed amplitude EEG and conventional EEG were compared.

The results of synchronous aEEG and cEEG were compared and there was significant difference between aEEG scores (between 0-13 points) and cEEG grade(grade 0-3) (p<0.05). Amplitude EEG detected seizures in 15 cases. No clinical seizure activity was noted in 8 (53%) of the cases during aEEG. Clinical seizures developed in 11 patients throughout aEEG recordings and 7 of these were detected (sensitivity 63.6%, positive predictive value 46.6%). It was assessed that the aEEG score of the patients who had clinical seizures was 4.26±3.17, the score of the cases who had no seizures was 6.29±2.6. The missing seizures in aEEG were myoclonic and brief seizures.

Monitorization with aEEG is suggested in newborns with acute brain injury to follow up the electrophysiological seizures and electrophysiological alterations. Amplitude EEG gave similar results to cEEG in detection of background rhytm. It is an easily applicable and alternative method. However, the sensitivity of aEEG in detecting seizure activity is low, particularly the brief seizures can be missed by using aEEG alone. Therefore, in suspicion of clinical seizure activity, it should be confirmed by cEEG.