Department of Pediatrics, Division of Child Neurology, Ege University Medical Faculty, Turkiye.
Department of Pediatrics, Division of Neonatology, Ege University Medical Faculty, Turkiye.
J Clin Neurosci. 2024 Aug;126:148-153. doi: 10.1016/j.jocn.2024.06.012. Epub 2024 Jun 17.
To compare the amplitude-integrated electroencephalography (aEEG) monitoring (short-term versus prolonged-period) for neonatal seizure detection and outcome.
The aEEG monitoring in a historical cohort (n = 88, preterm:42, and term:46) with neonatal encephalopathy between 2010-2022 was re-evaluated for neonatal seizures (electrographic, electro-clinical, and clinical seizures) and EEG background scoring. The cohort was dichotomized: group I (short-period with 6-12 h, n = 36) and group II (prolonged-period with 24-48 h, n = 52). Both monitoring types were evaluated for the diagnostic accuracy of the "patients with seizures" and for outcome characteristics (early death as well as adverse outcomes at 12 months of age).
A total of 67 (76 %) neonates of the cohort were diagnosed as "patients with seizures": electrographic-only seizures in 10 (15 %), electro-clinical seizures in 22 (33 %), and clinical-only seizures in 35 (52 %). The aEEG provides the "patients with seizures" in neonates with a 36.5 % rate with both types of monitoring: 17/36 (47.2 %) with short-term and 15/52 (28.8 %) with prolonged-period monitoring. The prolonged period aEEG had higher diagnostic values for seizure detection (sensitivity = 0.73 and negative predictivity value = 0.81). However, the aEEG background scores were similar for both types of aEEG monitoring, respectively (the mean ± SD: 4.73 ± 2.9 versus 4.4 ± 4. p = 0.837). The aEEG scoring was correlated with the magnitude of brain injury documented with MRI, the early death, and the adverse outcome at 12 months of age.
Both aEEG types are valuable for monitoring the "patients with seizures" and outcome characteristics.
比较振幅整合脑电图（aEEG）监测（短期与延长时间）在新生儿癫痫检测和结局中的作用。
对 2010 年至 2022 年期间患有新生儿脑病的历史队列（n=88，早产儿 42 例，足月儿 46 例）的 aEEG 监测进行重新评估，以检测新生儿癫痫（电、电临床和临床癫痫）和脑电图背景评分。该队列分为两组：I 组（6-12 小时，n=36）和 II 组（24-48 小时，n=52）。评估两种监测类型对“癫痫患者”的诊断准确性以及结局特征（早期死亡和 12 个月时的不良结局）。
该队列中共有 67 例（76%）新生儿被诊断为“癫痫患者”：电描记癫痫 10 例（15%），电临床癫痫 22 例（33%），临床癫痫 35 例（52%）。aEEG 以两种监测类型对新生儿“癫痫患者”的检出率为 36.5%：短期监测为 17/36（47.2%），延长时间监测为 15/52（28.8%）。延长时间 aEEG 对癫痫检测的诊断价值更高（敏感性为 0.73，阴性预测值为 0.81）。然而，两种类型的 aEEG 监测的脑电图背景评分相似（平均值±标准差：4.73±2.9 与 4.4±4. p=0.837）。aEEG 评分与 MRI 记录的脑损伤程度、早期死亡和 12 个月时的不良结局相关。
两种类型的 aEEG 均对监测“癫痫患者”和结局特征具有价值。
