How is the prognostic value of an abnormal neonatal EEG increased?

Updated: Oct 03, 2019
  • Author: Rosalia C Silvestri-Hobson, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Answer

Even more than in other epochs of life, in neonates the abnormal neonatal EEG has a prognostic value as opposed to a diagnostic value. Rarely, specific EEG patterns correspond to typical syndromes. Prognostic value can be increased with the following methods:

  • Early recordings, possibly within the first 48 hours of life - Markedly abnormal EEG patterns usually last for a relatively short time, followed by less abnormal or even normal patterns despite the absence of clinical resolution.

  • Prolonged recordings to include samples of different activity states - QS, for instance, is far more likely to show valuable maturation pattern abnormalities and yet is less likely to occur within short recording intervals in a compromised infant.

  • Serial EEGs obtained at short intervals to assess the rapid changes that are likely to occur in rapidly maturing, high-risk infants - Normalization of a previously abnormal pattern may indicate a minimal impact of a brain insult on maturation. Conversely, progressive deterioration of previously normal or moderately abnormal patterns favors the possibility of long-term neurological sequelae.

Because EEG abnormalities in neonates cover a broad spectrum, any classification is difficult and, in some cases, arbitrary. One possibility for classification would be to distinguish between diffuse and focal abnormalities and to categorize separately ictal and paroxysmal patterns in the presence of neonatal convulsions.


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