Abstract
Continuous EEG (cEEG) is a fundamental neurodiagnostic tool in the care of critically ill neonates and is increasingly recommended. cEEG enhances prognostication via assessment of the background brain activity, plays a role in predicting which neonates are at risk for seizures when combined with clinical factors, and allows for accurate diagnosis and management of neonatal seizures. Continuous EEG is the gold standard method for diagnosis of neonatal seizures and should be used for detection of seizures in high-risk clinical conditions, differential diagnosis of paroxysmal events, and assessment of response to treatment. High costs associated with cEEG are a limiting factor in its widespread implementation. Centralized remote cEEG interpretation, automated seizure detection, and pre-natal EEG are potential future applications of this neurodiagnostic tool.
Highlights
Continuous electroencephalography is full-array EEG recording, typically using a minimum of eight electrodes, performed over an extended period to non-invasively assess brain function
Recommended duration of monitoring is outlined by EEG indication in the American Clinical Neurophysiology Society (ACNS) guidelines: EEG background assessment requires a minimum of 1 h of recording to allow analysis of sleep-wake cycling, neonates at high risk for seizures should have 24 h of Continuous electroencephalography (cEEG) monitoring, and neonates with confirmed seizures should have cEEG until they have been seizure-free for at least 24 h [3]
Discontinuity on EEG for >30 s per min at 24 and 48 h of age was associated with MRI injury and worse neurodevelopmental outcome in term neonates with Hypoxic Ischemic Encephalopathy (HIE) who underwent therapeutic hypothermia
Summary
Reviewed by: Janette Mailo, University of Alberta, Canada Alison J. Continuous EEG (cEEG) is a fundamental neurodiagnostic tool in the care of critically ill neonates and is increasingly recommended. CEEG enhances prognostication via assessment of the background brain activity, plays a role in predicting which neonates are at risk for seizures when combined with clinical factors, and allows for accurate diagnosis and management of neonatal seizures. Continuous EEG is the gold standard method for diagnosis of neonatal seizures and should be used for detection of seizures in high-risk clinical conditions, differential diagnosis of paroxysmal events, and assessment of response to treatment. High costs associated with cEEG are a limiting factor in its widespread implementation. Centralized remote cEEG interpretation, automated seizure detection, and pre-natal EEG are potential future applications of this neurodiagnostic tool
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