Amplitude-integrated electroencephalography in full-term newborns without severe hypoxic-ischemic encephalopathy: case series.

AIM: To assess the diagnostic value of amplitude-integrated electroencephalography (EEG) in comparison to standard EEG in newborns without severe hypoxic-ischemic encephalopathy who were at risk for seizures.

METHODS: The study included a consecutive series of 18 term newborns without severe hypoxic-ischemic encephalopathy, but with clinical signs suspicious of epileptic seizures, history of loss of social contact, disturbance of muscle tone, hyperirritability, and/or jitteriness. Amplitude-integrated and standard EEG tracings were assessed for background pattern, epileptiform activity, and sleep-wake cycling.

RESULTS: Amplitude-integrated EEG and standard EEG recordings of 15 newborns were suitable for analysis. Only two different background patterns were seen on amplitude-integrated EEG and standard EEG, with the absence of severely abnormal background patterns. Of 15 newborns, epileptiform discharges were present on amplitude-integrated EEG in 3 newborns, and on standard EEG in 6 newborns. Sensitivity of seizures discharges on amplitude-integrated EEG to correspond with epileptiform discharges on standard EEG was 50%; specificity 100%,positive predictive value 100%, and negative predictive value 75%. Of 4 newborns suspected of having sleep myoclonus, amplitude-integrated EEG correctly identified the newborn who had epileptiform activity on standard EEG.

CONCLUSION: The diagnostic value of amplitude-integrated EEG monitoring of term newborns without severe hypoxic-ischemic encephalopathy is limited, but could have a role in evaluating presence or absence of epileptiform activity and in differentiating non-epileptic movement from seizures.