Abstract
Objective: The aim of this study is to describe a new objective method of detecting white matter
injury by use of refiltering function of digital EEG. Study design: The neonatal EEGs of 9 patients with PVL were analyzed retrospectively, and compared
with EEGs of 18 normal infants without PVL. Abnormal brushes were counted on the refiltered
EEG where low cut filter were set at 10 Hz so that slow waves were eliminated. Abnormal
brushes were defined as spindle-like fast wave bursts with maximal amplitudes higher
than 40 mV and frequencies between 13 Hz and 20 Hz, which were easily distinguishable
from a flat background. Results: The incidence of abnormal brushes in infants with PVL was 0.25/min, 0.45/min, 2.08/min,
and 0.62/min on the frontal, central, occipital, and temporal region, respectively.
The incidence in infants without PVL was 0.14/min, 0.08/min, 0.24/min, and 0.19/min,
respectively. Abnormal brushes were observed more often in infants with PVL on the
central, occipital, and temporal region than in infants without PVL. Localization
of abnormal brushes was also correlated with the lesion of white matter injury on
MR images and clinical outcome. Conclusion: Our results indicated that abnormal brushes on refiltered EEGs were strongly associated
with white matter injury.
Key words
Abnormal brushes - periventricular leukomalacia - digital EEG
References
- 1
Volpe J J.
The developing nervous system: a series of review articles.
Pediatr Res.
2001;
50
553-562
- 2
Dammann O, Leviton A.
Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn.
Pediatr Res.
1998;
42
1-8
- 3
Watanabe K, Hayakawa F, Okumura A.
Neonatal EEG: powerful tool in the assessment of brain damage in preterm infants.
Brain and Development.
1999;
21
361-372
- 4
Biagioni E, Bartalena L, Boldrini A, Pieri R, Cioni G.
Electroencephalography in infants with periventricular leukomalacia: prognostic features
at preterm and term age.
J Child Neurol.
2000;
15
1-6
- 5
Vermeulen R J, Sie L TL, Jonkman E J, Strijers R LM, Lafeber H N, Uitdehaag B MJ.
et al .
Predictive value of EEG in neonates with periventricular leukomalacia.
Dev Med Child Neurol.
2003;
45
586-590
- 6
Hayakawa F.
Okumura A. Kato T, Kuno K, Watanabe K. Determination of timing of brain injury in
preterm infants with periventricular leukomalacia with serial neonatal electroencephalography.
Pediatrics.
1999;
104
1077-1081
- 7
Okumura A, Hayakawa F, Kato T, Kuno K, Watanabe K.
Positive rolandic sharp waves in preterm infants with periventricular leukomalacia:
their relation to background electroencephalographic abnormalities.
Neuropediatrics.
1999;
30
278-282
- 8
Baud O, Allest A M, Lacaze-Masmonteil T, Zupan V, Nedelcoux H, Boitbias C. et al .
The early diagnosis of periventricular leukomalacia in premature infants with positive
rolandic sharp waves on serial electroencephalography.
J Pediatr.
1998;
132
813-817
- 9
Marret S, Parain D, Jeannot E, Eurin D, Fessard C.
Positive rolandic sharp waves in the EEG of the premature newborn: a five-year prospective
study.
Arch Dis Child.
1992;
67
948-951
- 10
Novotny E J, Tharp B R, Coen R W, Bejar R, Enzmann D, Vaucher Y E.
Positive rolandic sharp waves in the EEG of the premature infant.
Neurology.
1987;
37
1481-1486
- 11
Aso K, Scher M S, Barmada M A.
Neonatal electroencephalography and neuropathology.
J Clin Neurophysiol.
1989;
6
103-123
- 12
Hayakawa F, Okumura A, Kato T, Kuno K, Watanabe K.
Disorganized pattern: Chronic-stage EEG abnormality of the late neonatal period following
severely depressed EEG activities in early preterm infants.
Neuropediatrics.
1997;
28
272-275
- 13
Sofue A, Okumura A, Hayakawa F, Watanabe K. et al .
sharp waves in preterm infants with periventricular leukomalacia.
Pediatr Neurol.
2003;
29
214-217
- 14 Watanabe K.
the neonatal electroencephalorgram and sleep-cycle patterns. Eyre JA The Neurophysiological Examination of the Newborn Infant. London; Mac Keith
Press 1992: 11-47
- 15
Cukier F, Ander M, Dreyfus-Brisac C.
Apport de l'EEG au diagnostic des hemorragies intra-ventriculaires du prémature.
Revue d'electroencephalographie et de neurophysiologie clinique.
1972;
2
318-322
- 16
Okumura A, Hayakawa F, Kato T, Maruyama K, Kubota T, Suzuki M. et al .
Abnormal sharp transients on electroencephalograms in preterm infants with periventricular
leukomalacia.
J Pediatr.
2003;
143
26-30
- 17
Kubota T, Okumura A, Hayakawa F, Kato T, Itomi K, Kuno K. et al .
Relation between the date of cyst formation observable on ultrasonography and the
timing of injury determined by serial encephalography in preterm infants with periventricular
leukomalacia.
Brain Dev.
2001;
23
390-394
- 18
Kubota T, Okumura A, Hayakawa F, Kato T, Itomi K, Kuno K. et al .
Combination of neonatal electroencephalography and ultrasonography: sensitive means
in early diagnosis of periventricular leukomalacia.
Brain Dev.
2002;
24
698-702
Dr. Hiroyuki Kidokoro
Department of Pediatrics
Kasugai Municipal Hospital
1-1-1 Takaki-cho
Kasugai
Aichi, 486 - 8510
Japan
Email: kidokoro@wc4.so-net.ne.jp