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EDITED BY PROFESSOR YASSER METWALLY |
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Neonatal EEG |
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In recent years there has been much interest in using EEG to evaluate
full-term or premature neonates [1,2] due to the serious limitations
in performing an adequate neurologic examination. The neonate may be
confined to an isolette, may be intubated, or may be paralyzed for
ventilatory control. Under such circumstances, EEG is a very
important tool to assess an encephalopathic process or occurrence of
epileptic seizures. In addition, the background abnormalities have
been classified in neonates and used to predict neurologic outcome. Click
here for the whole story |
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Neonatal seizures |
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One of the major reasons an EEG is performed is if a neonate is
suspected of having epileptic seizures. In neonates, epileptic
seizures are often characterized clinically by subtle motor behavior
such as elevation of a limb, eye deviation, eyelid flutter, tonic
posturing, bicycling movements of the legs, apnea, and so on. The EEG
is indispensable in establishing the epileptic nature of the motor
activity by demonstrating an associated ictal pattern. There are many
unique features of neonatal seizures that are different from the
seizures encountered in older children and adults. The International
Classification of Epileptic Seizures is obviously inappropriate for
neonates. The immature brain at this age is unable to initiate and
sustain generalized epileptic discharges as in older children; hence,
typical tonic-clonic seizures do not occur. Many of the neonatal
seizures are subtle seizures as described above. At least some of
these do not show a close relationship to an EEG change. The
significance of such stereotypic motor events with no concomitant EEG
changes becomes a controversial issue regarding diagnosis and
management. Whether these events represent "epileptic"
dysfunction (not "picked up" by scalp electrodes) or
whether these stereotypic behaviors signify episodes of brain stem
release phenomena has yet to be resolved.
Click here for the whole story |
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Technical aspects in neonatal EEG |
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Several technical points are of crucial importance to optimize
neonatal EEG recording. The study should be long enough to include
active and quiet sleep; the total duration of the recording may
exceed the usual 30 minutes recommended in adults. In most neonates
it may be necessary to record the EEG for 45 to 60 minutes. Click
here for the whole story |
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