| Title: |
Combined Conventional and Amplitude-Integrated EEG Monitoring in Neonates: A Prospective Study |
| Authors: |
Buttle, Sarah Grace; Lemyre, Brigitte; Sell, Erick; Redpath, Stephanie; Bulusu, Srinivas; Webster, Richard J; Pohl, Daniela |
| Contributors: |
University of Ottawa |
| Source: |
Journal of Child Neurology ; volume 34, issue 6, page 313-320 ; ISSN 0883-0738 1708-8283 |
| Publisher Information: |
SAGE Publications |
| Publication Year: |
2019 |
| Description: |
Background/Objective: Seizure monitoring via amplitude-integrated EEG is standard of care in many neonatal intensive care units; however, conventional EEG is the gold standard for seizure detection. We compared the diagnostic yield of amplitude-integrated EEG interpreted at the bedside, amplitude-integrated EEG interpreted by an expert, and conventional EEG. Methods: Neonates requiring seizure monitoring received amplitude-integrated EEG and conventional EEG in parallel. Clinical events and amplitude-integrated EEG were interpreted at bedside. Subsequently, amplitude-integrated EEG and conventional EEG were independently analyzed by experienced neonatology and neurology readers. Sensitivity and specificity of bedside amplitude-integrated EEG as compared to expert amplitude-integrated EEG interpretation and conventional EEG were evaluated. Results: Thirteen neonates were monitored for an average duration of 33 hours (range 15-94, SD 25). Fourteen seizure-like events were detected by clinical observation, and 12 others by bedside amplitude-integrated EEG analysis. One of the clinical, and none of the bedside amplitude-integrated EEG events were confirmed as seizures on conventional EEG. Post hoc expert amplitude-integrated EEG interpretation revealed eight suspected seizures, all different from the ones detected by the bedside amplitude-integrated EEG team, of which one was confirmed via conventional EEG. Eight seizures were recorded on conventional EEG. Expert amplitude-integrated EEG interpretation had a sensitivity of 13% with 46% specificity for individual seizure detection, and a sensitivity of 50% with 46% specificity for detecting patients with seizures. Conclusion: Real-world bedside amplitude-integrated EEG monitoring failed to detect all seizures evidenced via conventional EEG, while misclassifying other events as seizures. Even post hoc expert amplitude-integrated EEG interpretation provided limited sensitivity and specificity. Considering the poor sensitivity and specificity of bedside ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1177/0883073819829256 |
| Availability: |
https://doi.org/10.1177/0883073819829256; https://journals.sagepub.com/doi/pdf/10.1177/0883073819829256; https://journals.sagepub.com/doi/full-xml/10.1177/0883073819829256 |
| Rights: |
https://journals.sagepub.com/page/policies/text-and-data-mining-license |
| Accession Number: |
edsbas.D1676C61 |
| Database: |
BASE |