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Does the first hour of continuous electroencephalography predict neonatal seizures?
- Source :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition; Mar2021, Vol. 106 Issue 2, pF162-F167, 6p
- Publication Year :
- 2021
-
Abstract
- <bold>Objective: </bold>Prolonged continuous video-electroencephalography (cEEG) is recommended for neonates at risk of seizures. The cost and expertise required to provide a real-time response to detected seizures often limits its utility. We hypothesised that the first hour of cEEG could predict subsequent seizures.<bold>Design and Setting: </bold>Retrospective multicentre diagnostic accuracy study.<bold>Patients: </bold>266 term neonates at risk of seizure or with suspected seizures.<bold>Intervention: </bold>The first hour of cEEG was graded by expert and novice interpreters as normal, mildly, moderately or severely abnormal; seizures were identified.<bold>Main Outcome Measures: </bold>Association between abnormalities in the first hour of cEEG and the presence of seizures during total cEEG monitoring.<bold>Results: </bold>50/98 (51%) of neonates who developed seizures had their first seizure in the first hour of cEEG monitoring. The 'time-to-event' risk of seizure from 0 to 96 hours was 0.38 (95% CI 0.32 to 0.44) while the risk in the first hour was 0.19 (95% CI 0.15 to 0.24). cEEG background was normal in 48% of neonates, mildly abnormal in 30%, moderately abnormal in 13% and severely abnormal in 9%. Inter-rater agreement for determination of background was very good (weighted kappa=0.81, 95% CI 0.72 to 0.91). When neonates with seizures during the first hour were excluded, an abnormal background resulted in 2.4 times increased risk of seizures during the subsequent monitoring period (95% CI 1.3 to 4.4, p<0.003) while a severely abnormal background resulted in a sevenfold increased risk (95% CI 3.4 to 14.3, p<0.0001).<bold>Conclusions: </bold>The first hour of cEEG in at-risk neonates is useful in identifying and predicting whether seizures occur during cEEG monitoring up to 96 hours. This finding enables identification of high-risk neonates who require closer observation. [ABSTRACT FROM AUTHOR]
- Subjects :
- SEIZURES (Medicine)
ELECTROENCEPHALOGRAPHY
NEWBORN infants
DIAGNOSIS of neonatal diseases
RESEARCH
CLINICAL trials
TIME
RESEARCH methodology
GESTATIONAL age
RETROSPECTIVE studies
MEDICAL cooperation
EVALUATION research
SEVERITY of illness index
COMPARATIVE studies
RANDOMIZED controlled trials
KAPLAN-Meier estimator
SPASMS
Subjects
Details
- Language :
- English
- ISSN :
- 13592998
- Volume :
- 106
- Issue :
- 2
- Database :
- Complementary Index
- Journal :
- Archives of Disease in Childhood -- Fetal & Neonatal Edition
- Publication Type :
- Academic Journal
- Accession number :
- 148845294
- Full Text :
- https://doi.org/10.1136/archdischild-2020-318985