Chapter 36 EEG in neonates. What does the neonatal EEG tell about prognosis?

Abstract

Publisher Summary The prognosis of the child in the neonatal intensive care unit (NICU) is of paramount importance in the decision to continue or stop treatment. Reliable measures of psychomotor development in the far future are indispensable in such decisions. The electroencephalography (EEG) has the advantage that most technicians can easily apply the method, even in small children. EEG gives not only prognostic features but, in contrast to evoked potentials, gives information on epileptic discharges as well. This chapter discusses a study to evaluate neonatal EEG criteria that are widely used for the prediction of outcome. The study was performed in a large group of children born around term in which follow-up was sufficiently long to give insight into the final performance of the patients. EEGs were recorded on day 2 or 3 of life. Only in very exceptional cases was the EEG made in the first 24 hours of life. This was done only in those patients for whom (suspicion of) epileptic seizures urged early registration. Many children needed drug treatment, in particular anti-epileptic drugs. Blood levels of medication that might have sedative effects were measured. The follow-up of all patients was at least two years and up to six years. The children were regularly seen by a senior pediatrician or a child neurologist for at least the first two years of life. The psychomotor performance of the children was assessed.