1665 A CHARACTERISTIC EEG PATTERN IN MULTIFOCAL CEREBRAL WHITE MATTER NECROSIS

Abstract

Surface positive sharp waves (PRS) in central (Rolandic) regions of the premature infant's electroencephalogram (EEC) were associated with intraventricular hemorrhage (IVH) in 1972. Later studies using CT scans confirmed the PRS-IVH relationship. Current studies with real time echoencephalography (RTE) and autopsies suggest PRS are associated with multifoca] necrosis (MFN) of the cerebral white matter in the presence or absence of IVH. MFN was diagnosed in 30 premature infants. The number of infants with PRS positive EEG's were as follows: PRS were present during the progressive phase of MFN which appears on RTE as paraventricular echodensities and emerging cavitations. No PRS were observed when cavitations remained focal or were resorbing. RPS were recorded from the central vertex (Cz) electrode in nearly all cases. In summary, PRS on a preterm infant's EEG suggest the need for serial EEC and RTE evaluations to determine the presence and evolution of cerebral white matter necrosis, even if IVH is present.