METHODS: The aEEG monitoring in a historical cohort (n = 88, preterm:42, and term:46) with neonatal encephalopathy between 2010-2022 was re-evaluated for neonatal seizures (electrographic, electro-clinical, and clinical seizures) and EEG background scoring. The cohort was dichotomized: group I (short-period with 6-12 h, n = 36) and group II (prolonged-period with 24-48 h, n = 52). Both monitoring types were evaluated for the diagnostic accuracy of the \"patients with seizures\" and for outcome characteristics (early death as well as adverse outcomes at 12 months of age).
RESULTS: A total of 67 (76 %) neonates of the cohort were diagnosed as \"patients with seizures\": electrographic-only seizures in 10 (15 %), electro-clinical seizures in 22 (33 %), and clinical-only seizures in 35 (52 %). The aEEG provides the \"patients with seizures\" in neonates with a 36.5 % rate with both types of monitoring: 17/36 (47.2 %) with short-term and 15/52 (28.8 %) with prolonged-period monitoring. The prolonged period aEEG had higher diagnostic values for seizure detection (sensitivity = 0.73 and negative predictivity value = 0.81). However, the aEEG background scores were similar for both types of aEEG monitoring, respectively (the mean ± SD: 4.73 ± 2.9 versus 4.4 ± 4. p = 0.837). The aEEG scoring was correlated with the magnitude of brain injury documented with MRI, the early death, and the adverse outcome at 12 months of age.
CONCLUSIONS: Both aEEG types are valuable for monitoring the \"patients with seizures\" and outcome characteristics.
方法:重新评估了2010-2022年间新生儿脑病的历史队列(n=88,早产:42,足月:46)中的aEEG监测新生儿癫痫发作(电图,电临床,和临床癫痫发作)和脑电图背景评分。将队列分为两分法:I组(短期6-12小时,n=36)和II组(延长24-48小时,n=52)。评估了两种监测类型的“癫痫患者”的诊断准确性和结局特征(早期死亡以及12个月大时的不良结局)。
结果:该队列中共有67名(76%)新生儿被诊断为“癫痫发作患者”:仅有10例(15%)的癫痫发作,电临床癫痫发作22例(33%),35例(52%)仅临床发作。aEEG为新生儿的“癫痫患者”提供了36.5%的两种监测方法:短期监测17/36(47.2%),长期监测15/52(28.8%)。长时间aEEG对癫痫发作检测具有较高的诊断价值(敏感性=0.73,阴性预测值=0.81)。然而,两种类型的aEEG监测的aEEG背景评分相似,分别(平均值±SD:4.73±2.9对4.4±4。p=0.837)。aEEG评分与MRI记录的脑损伤程度相关,早期死亡,以及12月龄时的不良结局。
结论:两种aEEG类型对于监测“癫痫患者”和结果特征都有价值。