P 70 Amplitude-integrated EEG (AEEG) and Conventional EEG in the Diagnosis of Seizures and Cerebral Infarction in a Newborn

Abstract

Introduction: Newborn seizures are one of the most common neurological emergencies in the neonatal period, especially in the first 1-2 days to the first week after birth. In most cases, it is an acute symptomatic condition (cerebral infarction, bleeding, infection, etc.). Therefore, timely detection of seizures determines the further treatment tactics and prognosis. The further development of the child depends on this. It underlines the relevance of this topic. Materials and Methods: We present the case of a newborn baby. Gestational age (weeks + days): 37 + 2. Birth weight 2935 G. Length: 51 cm. Head circumference: 34 cm. Perinatal B-streptococcal infection. Sepsis. After birth, repetitive twitching of the right extremities, head and eye movements to the right. The child was monitored along with vital parameters by means of an amplitude-integrated EEG (AEEG). In the dynamics, the analysis and interpretation of AEEG, EEG changes with EEG amplitude mapping, EEG frequency mapping and MRI were carried out. Results: The AEEG showed repetitive seizures on the left side and a side difference (sudden increase especially in the lower edge and partly also in the upper edge, triggered by the permanent increased amplitude in the EEG on the left). No epiactivity on the right side. In the conventional EEG, repetitive epilepsy-typical patterns in the form of spike-sharp waves limited to the left hemisphere at the age of 3 days. An anticonvulsant treatment was recommended (phenobarbital 7.5 mg 2 x gl). MRI: the image of an acute ischemic event in the area of the middle cerebral artery on the left frontoparietotemporal. EEG control on the 6th day: significant amplitude asymmetry (T4O2>T3O1, C4O2>C3O1, FP2C4>FP1C3). No epilepsy-typical potentials, no seizure patterns, no hypersynchronous activity. Conclusion: Our case study describes a child with neonatal seizures and a media infarction on the left. The amplitude-integrated EEG with two channels (C3-P3 and C4-P4) can be an early marker of neonatal seizures and unilateral cerebral infarctions with a clear side difference. The amplitude- integrated EEG should be used as a screening method for the detection of high-risk newborns who need the conventional EEG and MRI for final verification and diagnosis. It is important for further treatment tactics and prognosis.