Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands.
Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, University Utrecht, Utrecht, the Netherlands.
Clin Neurophysiol. 2021 Jul;132(7):1452-1461. doi: 10.1016/j.clinph.2021.02.400. Epub 2021 Apr 16.
Neonatal seizures are often the first symptom of perinatal brain injury. High-frequency oscillations (HFOs) are promising new biomarkers for epileptogenic tissue and can be found in intracranial and surface EEG. To date, we cannot reliably predict which neonates with seizures will develop childhood epilepsy. We questioned whether epileptic HFOs can be generated by the neonatal brain and potentially predict epilepsy.
We selected 24 surface EEGs sampled at 2048 Hz with 175 seizures from 16 neonates and visually reviewed them for HFOs. Interictal epochs were also reviewed.
We found HFOs in thirteen seizures (7%) from four neonates (25%). 5025 ictal ripples (rate 10 to 1311/min; mean frequency 135 Hz; mean duration 66 ms) and 1427 fast ripples (rate 8 to 356/min; mean frequency 298 Hz; mean duration 25 ms) were marked. Two neonates (13%) showed interictal HFOs (285 ripples and 25 fast ripples). Almost all HFOs co-occurred with sharp transients. We could not find a relationship between neonatal HFOs and outcome yet.
Neonatal HFOs co-occur with ictal and interictal sharp transients.
The neonatal brain can generate epileptic ripples and fast ripples, particularly during seizures, though their occurrence is not common and potential clinical value not evident yet.
新生儿发作通常是围产期脑损伤的首发症状。高频振荡（HFOs）是一种有前途的致痫组织新生物标志物，可在颅内和表面 EEG 中发现。迄今为止，我们无法可靠地预测哪些有发作的新生儿会发展为儿童癫痫。我们质疑新生儿大脑是否可以产生癫痫 HFOs，并有可能预测癫痫。
我们从 16 名新生儿中选择了 24 份以 2048 Hz 采样的表面 EEG，共 175 次癫痫发作，并对其进行了 HFOs 的视觉审查。还对发作间期进行了回顾。
我们在 4 名新生儿（25%）的 13 次发作（7%）中发现了 HFOs。标记了 5025 次发作性棘波（频率为 10 至 1311/min；平均频率为 135 Hz；平均持续时间为 66 ms）和 1427 次快棘波（频率为 8 至 356/min；平均频率为 298 Hz；平均持续时间为 25 ms）。有 2 名新生儿（13%）表现出发作间期 HFOs（285 个棘波和 25 个快棘波）。几乎所有的 HFOs 都与锐波瞬态同时发生。我们还没有发现新生儿 HFOs 与结局之间的关系。
新生儿 HFOs 与发作性和发作间期的锐波瞬态同时发生。
新生儿大脑可以产生癫痫性棘波和快棘波，特别是在发作期间，但它们的发生并不常见，潜在的临床价值尚不清楚。
