The prognostic value of amplitude-integrated EEG in full-term neonates with seizures

PLoS One. 2013 Nov 13;8(11):e78960. doi: 10.1371/journal.pone.0078960. eCollection 2013.

Abstract

Neonatal seizures pose a high risk for adverse outcome in survived infants. While the prognostic value of amplitude-integrated electroencephalogram (aEEG) is well established in neonates with encephalopathy and asphyxia, neonatal seizure studies focusing on the direct correlation between early aEEG measurement and subsequent neurologic outcome are scarce. In this study, the prognostic value of aEEG features was systematically analyzed in 143 full-term neonates to identify prognostic indicators of neurodevelopmental outcome. Neonatal aEEG features of background pattern, cyclicity, and seizure activity, as well as the etiology of neonatal seizures, were significantly associated with neurodevelopmental outcome at one year of age. aEEG background pattern was highly associated with neurologic outcomes (χ² = 116.9), followed by aEEG cyclicity (χ² = 87.2) and seizure etiology (χ² = 79.3). Multiple linear regression showed that the four predictors explained 71.2% of the variation in neurological outcome, with standardized β coefficients of 0.44, 0.24, 0.22, and 0.14 for the predictors of aEEG background pattern, cyclicity, etiology, and aEEG seizure activity, respectively. This clinically applicable scoring system based on etiology and three aEEG indices would allow pediatricians to assess the risk for neurodevelopmental impairment and facilitate an early intervention in newborns developing seizures.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anticonvulsants / therapeutic use
  • Electroencephalography
  • Evaluation Studies as Topic
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prognosis
  • Retrospective Studies
  • Seizures / diagnosis*
  • Seizures / drug therapy
  • Seizures / etiology
  • Seizures / physiopathology
  • Treatment Outcome

Substances

  • Anticonvulsants

Grants and funding

This study was funded by the National Natural Science Foundation of China (31300867; 31300847; 91132704). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.