The Use of the Electroencephalogram in the Confirmation of Seizures in Premature and Neonatal Infants

Abstract

This study, involving 236 patients (pts) of 24-48 wks conceptional age, was designed to determine how well the interictal EEG could confirm a seizure (SZ) disorder in prematures and neonates. "Burnt-out" (B) sharp waves were frequently (80%) associated with SZ, as were positive (P) sharp waves (75%). The latter, more often on the temporal than central areas, were found in 1/3 of pts with intraventricular hemorrhage (IVH) and nearly 1/3 with P sharp waves had IVH. Other focal (negative) discharges were found in the majority of the pts and their frequency of occurrence was investigated as the major variable to confirm a SZ disorder. Along with B and P sharp waves, the other focal discharges at the average frequency of 1/min confirmed too few of the SZ pts (36 %) and at 0.3/min included too many (34 %) of the NON-SZ pts. Using the criterion of 0.5/min, only 18% of the NON-SZ pts were included as false positives, but over half of SZ pts (52%) were then identified and 73% with these discharges did have SZ. Thus, this study has emphasized that correlation and confirmation of a SZ disorder likely depends on quantified, statistical considerations, especially the frequency of occurrence of an interictal discharge.

Key words

Seizures - Prematures and neonates - EEG - Spikes and sharp waves