Document Detail

Effect of treatment of subclinical neonatal seizures detected with aEEG: randomized, controlled trial.
MedLine Citation:
PMID:  20100767     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The goals were to investigate how many subclinical seizures in full-term neonates with hypoxic-ischemic encephalopathy (HIE) would be missed without continuous amplitude-integrated electroencephalography (aEEG) and whether immediate treatment of both clinical and subclinical seizures would result in a reduction in the total duration of seizures and a decrease in brain injury, as seen on MRI scans. METHODS: In this multicenter, randomized, controlled trial, term infants with moderate to severe HIE and subclinical seizures were assigned randomly to either treatment of both clinical seizures and subclinical seizure patterns (group A) or blinding of the aEEG registration and treatment of clinical seizures only (group B). All recordings were reviewed with respect to the duration of seizure patterns and the use of antiepileptic drugs (AEDs). MRI scans were scored for the severity of brain injury. RESULTS: Nineteen infants in group A and 14 infants in group B were available for comparison. The median duration of seizure patterns in group A was 196 minutes, compared with 503 minutes in group B (not statistically significant). No significant differences in the number of AEDs were seen. Five infants in group B received AEDs when no seizure discharges were seen on aEEG traces. Six of 19 infants in group A and 7 of 14 infants in group B died during the neonatal period. A significant correlation between the duration of seizure patterns and the severity of brain injury in the blinded group, as well as in the whole group, was found. CONCLUSIONS: In this small group of infants with neonatal HIE and seizures, there was a trend for a reduction in seizure duration when clinical and subclinical seizures were treated. The severity of brain injury seen on MRI scans was associated with a longer duration of seizure patterns.
Linda G M van Rooij; Mona C Toet; Alexander C van Huffelen; Floris Groenendaal; Wijnand Laan; Alexandra Zecic; Timo de Haan; Irma L M van Straaten; Sabine Vrancken; Gerda van Wezel; Jaqueline van der Sluijs; Henk Ter Horst; Danilo Gavilanes; Sabrina Laroche; Gunnar Naulaers; Linda S de Vries
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Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-01-25
Journal Detail:
Title:  Pediatrics     Volume:  125     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2010 Feb 
Date Detail:
Created Date:  2010-02-03     Completed Date:  2010-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e358-66     Citation Subset:  AIM; IM    
Wilhelmina Children's Hospital, Department of Neonatology, KE 04.123.1, PO Box 85090, 3508 AB Utrecht, Netherlands.
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MeSH Terms
Electroencephalography / methods*
Hypoxia-Ischemia, Brain / complications*,  physiopathology
Infant, Newborn
Magnetic Resonance Imaging
Monitoring, Physiologic
Seizures / diagnosis*,  drug therapy*,  etiology

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