Doménech Martínez E, Castro Conde J R, Lorenzo C R, Méndez Pérez A, González-Azpeitia G
Departamento de Pediatría, Hospital Universitario de Canarias, Facultad de Medicina de La Laguna.
An Esp Pediatr. 1993 Jun;38(6):517-23.
In order to check the prognostic implications of EEG tracings in hypoxic-ischemic encephalopathy (HIE), we carried out prospective EEG recordings in 116 newborn babies (65 term and 51 premature) admitted to our neonatal intensive care unit as a result of perinatal asphyxia. Forty term neonates were found to have critical and/or intercritical epileptiform EEG alterations; the developmental results of 23 of these cases (57.5%) were adverse and were favorable in 17 cases (42.5%). Given that unfavorable results occurred in only 4 of the other 25 term neonates, the epileptiform EEG alterations were statistically significant for adverse developmental results (p < 0.005). Of the premature neonates, 29 were found to have critical and/or intercritical epileptiform EEG alterations. The developmental results were adverse in 19 of these children (65.5%) and favorable in 10 cases (34.8%). The statistical evaluation in this case showed a barely significant difference (p < 0.005) between epileptiform EEG alterations and poor developmental outcome when uncorrected age was used, and no statistically significant difference when corrected age was used. Thus, we conclude that although epileptiform EEG anomalies may serve as markers for neurological development impairments, they must be considered in conjunction with the background EEG tracing.
为了检查脑电图描记在缺氧缺血性脑病(HIE)中的预后意义,我们对因围产期窒息入住我院新生儿重症监护病房的116例新生儿(65例足月儿和51例早产儿)进行了前瞻性脑电图记录。发现40例足月儿有严重和/或临界性癫痫样脑电图改变;其中23例(57.5%)发育结果不良,17例(42.5%)发育结果良好。鉴于其他25例足月儿中只有4例出现不良结果,癫痫样脑电图改变对不良发育结果具有统计学意义(p<0.005)。在早产儿中,发现29例有严重和/或临界性癫痫样脑电图改变。其中19例(65.5%)儿童发育结果不良,10例(34.8%)发育结果良好。在这种情况下,当使用未校正年龄时,癫痫样脑电图改变与不良发育结局之间的统计学评估显示出几乎显著的差异(p<0.005),而当使用校正年龄时,则无统计学显著差异。因此,我们得出结论,虽然癫痫样脑电图异常可能作为神经发育损害的标志物,但必须结合背景脑电图描记进行考虑。