947 Evaluation of Paroxysmal Activity on Aeeg and Eeg Tracings During Cool Cap Treatment of Asphyxiated Newborns with Hie

Abstract

Aims: To evaluate the incidence, type and duration of paroxysmal activity on aEEG and simultaneous EEG activity during therapeutic cranio-cerebral hypothermia in term severely and moderately asphyxiated newborns. Methods: aEEG tracings of 23 newborn infants with severe and moderate HIE undergoing therapeutic cranio-cerebral hypothermia were studied. Singlechannel aEEG together with regular EEG were obtained with OLYMPIC GFM 6000 monitor. Bifrontal placement of electrodes was used. An interelectrode impedance was maintained at the level of 5 kOhm. aEEG was monitored continuously from the moment of diagnosis of HIE to the 15-th day of life. All the aEEG tracings during the entire period of aEEG monitoring were reviewed together with regular EEG tracings in zones of concern. Results: There were “saw tooth” patterns or episodes of elevation of the lower margin of band of aEEG activity detected in the tracings of all 23 babies undergoing cool cap treatment with simultaneous paroxysmal activity on EEG. In all the patients these encephalographic changes were treated with phenobarbital. In 14 cases aEEG seizures were observed together with clinically apparent seizures, at least before cooling. In majority of patients aEEG seizures were observed throughout and beyond the period of head cooling despite the phenobarbital treatment. Conclusions: Electroencephalographic seizures are common in asphyxiated newborn undergoing neuroprotective hypothermia, in many cases without clinical manifestations. aEEG monitoring may be helpful in evaluation of CNS condition and indicates that the anticonvulsive treatment probably needs to be enhanced during cranio-cerebral hypothermia.