Neurological prognosis of perinatal asphyxia: a clinical and electroencephalographic study

ABSTRACT

Perinatal asphyxia complicated by hypoxic ischemic brain injury still remains the source of serious and definitive neurological lesions. To establish a relation between clinical signs, EEC and outcome of perinatal asphyxia. A cohort of 64 neonates from the Neonatal Intensive Care Unit [NICU] Faculty of Medicine, Cairo University was enrolled in a prospective study. All the newborns had at least one criteria of perinatal asphyxia. Full clinical assessment and staging was done immediately after birth and one month later. An early electroencephalogram [EEG] was carried out on seventh day of life. Multivariate analysis based on the intake variables identified hypotonia, spasticity, weak or absent crying and EEG epileptogenic activity as independent predictors of poor outcome. All patients with mild encephalopathy had normal EEG background activity. Severe stages of asphyxia were significantly associated with low amplitude background, burst suppression pattern and other forms of background abnormalities as well as non-reactivity. Epileptogenic activity in EEG of these neonates increased the likelihood of uncontrolled seizures. Our study confirms the interest of the association of clinical settings and EEG tracings in the diagnosis and the prognostic of the hypoxic-ischemic encephalopathy in neonates