Ictal electroencephalography [EEG] findings as predictors of neurodevelopment outcome of neonatal seizures

ABSTRACT

Neonatal electroencephalography has been found to be a good predictive factor of the neurodevelopmental outcome. The aim of this study was to identify if the electrical ictal findings present on the electroencephalography [EEG] recordings are related to the outcome of newborns with neonatal seizures. The study based on prospective evaluation of newborns admitted to the Neonatal Intensive Care Unit at the University of Tanta between may 2004 and June 2006. Forty subjects were enrolled in the study on basis of the following inclusion criteria presence on the first EEG of at least I seizure, neurodevelopmental follow-up until 18 months of corrected age, and performance of several ultrasound brain scans during the neonatal period and of at least I cerebral MRI within the first year of life. For each seizure, the following were considered onset topography, morphology of the epileptiform discharges, spread of the discharge, number of electro graphic regions of seizure onset, number of seizures per hour, duration of the seizures, and the Ictal Fraction [=total duration of the seizures/duration of the EEG recording x hour]. At the last follow-up, the unfavorable neurodevelopmental outcome seems significantly related to the moderate/severe background activity abnormalities .006], to spread of ictal discharge to the contralateral hemisphere [p=.02], and to the Ictal Fraction, when it exceeds 10 minutes. [p=.036]. In conclusion, the analysis of the propagation of the iotal discharge and of the ictal Fraction might suggest significant prognostic information since the first hours of life