Detection of subclinical electroencephalographic seizure patterns with multichannel amplitude-integrated EEG in full-term neonates

Bourez-Swart, Mireille D.; van Rooij, Linda; Rizzo, Cristiano; de Vries, Linda S.; Toet, Mona C.; Gebbink, Tineke A.; Ezendam, Anja G.J.; van Huffelen, Alexander C.

doi:10.1016/j.clinph.2009.08.015

« Previous Next »Clinical Neurophysiology
Volume 120, Issue 11 , Pages 1916-1922, November 2009

Detection of subclinical electroencephalographic seizure patterns with multichannel amplitude-integrated EEG in full-term neonates

Mireille D. Bourez-Swart
- Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands
- Corresponding author. Address: Stichting Epilepsie Instellingen Nederland (SEIN), Locatie Heemstaete, Dr. Denekampweg 20, 8025 BV Zwolle, The Netherlands. Tel.: +31 (0) 38 4557171; fax: +31 (0) 38 4557170.
Linda van Rooij
- Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht, The Netherlands
Cristiano Rizzo
- Micromed Spa, Mogliano Veneto – TV, Italy
Linda S. de Vries
- Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht, The Netherlands
Mona C. Toet
- Department of Neonatology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Utrecht, The Netherlands
Tineke A. Gebbink
- Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands
Anja G.J. Ezendam
- Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands
Alexander C. van Huffelen
- Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children’s Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands

Accepted 21 August 2009.

Abstract

Objective

To compare the seizure pattern detection rate of single-channel and multichannel amplitude-integrated EEG (aEEG), using conventional EEG (cEEG) as a gold standard, in full-term neonates with hypoxic–ischemic encephalopathy. The optimal electrode derivation for seizure detection with single-channel aEEG was also investigated.

Methods

Twelve infants with cEEG seizure patterns (⩾10s) were investigated. cEEG signals were transformed into aEEG signals. Seizure patterns and the number of patients identified with ⩾1 seizure patterns were calculated for single- and multichannel aEEG.

Results

On cEEG, 121 seizure patterns with a mean duration of 58s were identified, 68% of which occurred over the centrotemporal region. The sensitivity of aEEG for the detection of seizure patterns was 30% (C.I.: 0.22–0.38) for single-channel aEEG and 39% (C.I.: 0.31–0.48) for multichannel aEEG. Multichannel aEEG identified all patients with ⩾1 seizure pattern (C.I.: 0.75–1.00), whereas single-channel aEEG (with C4–C3 as the optimal electrode derivation) identified all but one of the patients (C.I.: 0.66–0.99).

Conclusions

Seizure pattern detection rate is slightly better with multichannel aEEG compared with single-channel (C4–C3) aEEG. Multichannel aEEG identified correctly all patients with ⩾1 seizure pattern in this small selection of patients.

Significance

Single-channel aEEG may detect most patients (in a selected group) with severe neonatal seizures patterns; patient identification can be improved using multichannel recordings.

Keywords: Neonatal seizures, Neonatal EEG, Amplitude-integrated EEG, Cerebral function monitor