Early EEG findings in hypoxic-ischemic encephalopathy predict outcomes at 2 years.

Hdl Handle:
http://hdl.handle.net/10147/200958
Title:
Early EEG findings in hypoxic-ischemic encephalopathy predict outcomes at 2 years.
Authors:
Murray, Deirdre M; Boylan, Geraldine B; Ryan, Cornelius A; Connolly, Sean
Affiliation:
Department of Paediatrics and Child Health, University College Cork, Cork, Ireland. d.murray@ucc.ie
Citation:
Early EEG findings in hypoxic-ischemic encephalopathy predict outcomes at 2 years. 2009, 124 (3):e459-67 Pediatrics
Journal:
Pediatrics
Issue Date:
Sep-2009
URI:
http://hdl.handle.net/10147/200958
DOI:
10.1542/peds.2008-2190
PubMed ID:
19706569
Additional Links:
http://pediatrics.aappublications.org/content/124/3/e459.full.pdf+html
Abstract:
We examined the evolution of electroencephalographic (EEG) changes after hypoxic injury.; Continuous, multichannel, video-EEG was recorded for term infants with hypoxic-ischemic encephalopathy, from <6 hours to 72 hours after delivery. One-hour segments at 6, 12, 24, and 48 hours of age of the EEG were analyzed visually, and neurologic outcome was assessed at 24 months.; Forty-four infants completed neurodevelopmental follow-up. Of those, 20 (45%) had abnormal outcomes. The EEG grade assigned correlated significantly with outcome. EEG abnormalities improved with time, with the worst EEG grade seen on the earliest recording in all cases. The best predictive ability was seen at 6 hours of age (area under the receiver operator characteristic curve: 0.958 [95% confidence interval: 0.88-1.04]; P = .000). Normal/mildly abnormal EEG results at 6, 12, or 24 hours had 100% positive predictive values for normal outcomes and negative predictive values of 67% to 76%. By 48 hours, many of the EEG findings had improved significantly. This led to the positive predictive value of abnormal EEG results being greater at 48 hours (93%), with a concurrent negative predictive value of 71%. EEG features that were associated with abnormal outcomes were background amplitude of <30 microV, interburst interval of >30 seconds, electrographic seizures, and absence of sleep-wake cycling at 48 hours.; Early EEG is a reliable predictor of outcome in HIE. A normal or mildly abnormal EEG results within 6 hours after birth were associated with normal neurodevelopmental outcomes at 24 months.
Item Type:
Article
Language:
en
Description:
OBJECTIVE: We examined the evolution of electroencephalographic (EEG) changes after hypoxic injury. METHODS: Continuous, multichannel, video-EEG was recorded for term infants with hypoxic-ischemic encephalopathy, from <6 hours to 72 hours after delivery. One-hour segments at 6, 12, 24, and 48 hours of age of the EEG were analyzed visually, and neurologic outcome was assessed at 24 months. RESULTS: Forty-four infants completed neurodevelopmental follow-up. Of those, 20 (45%) had abnormal outcomes. The EEG grade assigned correlated significantly with outcome. EEG abnormalities improved with time, with the worst EEG grade seen on the earliest recording in all cases. The best predictive ability was seen at 6 hours of age (area under the receiver operator characteristic curve: 0.958 [95% confidence interval: 0.88-1.04]; P = .000). Normal/mildly abnormal EEG results at 6, 12, or 24 hours had 100% positive predictive values for normal outcomes and negative predictive values of 67% to 76%. By 48 hours, many of the EEG findings had improved significantly. This led to the positive predictive value of abnormal EEG results being greater at 48 hours (93%), with a concurrent negative predictive value of 71%. EEG features that were associated with abnormal outcomes were background amplitude of <30 microV, interburst interval of >30 seconds, electrographic seizures, and absence of sleep-wake cycling at 48 hours. CONCLUSIONS: Early EEG is a reliable predictor of outcome in HIE. A normal or mildly abnormal EEG results within 6 hours after birth were associated with normal neurodevelopmental outcomes at 24 months.
MeSH:
Child Development; Electroencephalography; Female; Follow-Up Studies; Humans; Hypoxia-Ischemia, Brain; Infant, Newborn; Male; Predictive Value of Tests; Prospective Studies; Time Factors
ISSN:
1098-4275

Full metadata record

DC FieldValue Language
dc.contributor.authorMurray, Deirdre Men
dc.contributor.authorBoylan, Geraldine Ben
dc.contributor.authorRyan, Cornelius Aen
dc.contributor.authorConnolly, Seanen
dc.date.accessioned2012-01-09T16:05:36Z-
dc.date.available2012-01-09T16:05:36Z-
dc.date.issued2009-09-
dc.identifier.citationEarly EEG findings in hypoxic-ischemic encephalopathy predict outcomes at 2 years. 2009, 124 (3):e459-67 Pediatricsen
dc.identifier.issn1098-4275-
dc.identifier.pmid19706569-
dc.identifier.doi10.1542/peds.2008-2190-
dc.identifier.urihttp://hdl.handle.net/10147/200958-
dc.descriptionOBJECTIVE: We examined the evolution of electroencephalographic (EEG) changes after hypoxic injury. METHODS: Continuous, multichannel, video-EEG was recorded for term infants with hypoxic-ischemic encephalopathy, from <6 hours to 72 hours after delivery. One-hour segments at 6, 12, 24, and 48 hours of age of the EEG were analyzed visually, and neurologic outcome was assessed at 24 months. RESULTS: Forty-four infants completed neurodevelopmental follow-up. Of those, 20 (45%) had abnormal outcomes. The EEG grade assigned correlated significantly with outcome. EEG abnormalities improved with time, with the worst EEG grade seen on the earliest recording in all cases. The best predictive ability was seen at 6 hours of age (area under the receiver operator characteristic curve: 0.958 [95% confidence interval: 0.88-1.04]; P = .000). Normal/mildly abnormal EEG results at 6, 12, or 24 hours had 100% positive predictive values for normal outcomes and negative predictive values of 67% to 76%. By 48 hours, many of the EEG findings had improved significantly. This led to the positive predictive value of abnormal EEG results being greater at 48 hours (93%), with a concurrent negative predictive value of 71%. EEG features that were associated with abnormal outcomes were background amplitude of <30 microV, interburst interval of >30 seconds, electrographic seizures, and absence of sleep-wake cycling at 48 hours. CONCLUSIONS: Early EEG is a reliable predictor of outcome in HIE. A normal or mildly abnormal EEG results within 6 hours after birth were associated with normal neurodevelopmental outcomes at 24 months.en
dc.description.abstractWe examined the evolution of electroencephalographic (EEG) changes after hypoxic injury.-
dc.description.abstractContinuous, multichannel, video-EEG was recorded for term infants with hypoxic-ischemic encephalopathy, from <6 hours to 72 hours after delivery. One-hour segments at 6, 12, 24, and 48 hours of age of the EEG were analyzed visually, and neurologic outcome was assessed at 24 months.-
dc.description.abstractForty-four infants completed neurodevelopmental follow-up. Of those, 20 (45%) had abnormal outcomes. The EEG grade assigned correlated significantly with outcome. EEG abnormalities improved with time, with the worst EEG grade seen on the earliest recording in all cases. The best predictive ability was seen at 6 hours of age (area under the receiver operator characteristic curve: 0.958 [95% confidence interval: 0.88-1.04]; P = .000). Normal/mildly abnormal EEG results at 6, 12, or 24 hours had 100% positive predictive values for normal outcomes and negative predictive values of 67% to 76%. By 48 hours, many of the EEG findings had improved significantly. This led to the positive predictive value of abnormal EEG results being greater at 48 hours (93%), with a concurrent negative predictive value of 71%. EEG features that were associated with abnormal outcomes were background amplitude of <30 microV, interburst interval of >30 seconds, electrographic seizures, and absence of sleep-wake cycling at 48 hours.-
dc.description.abstractEarly EEG is a reliable predictor of outcome in HIE. A normal or mildly abnormal EEG results within 6 hours after birth were associated with normal neurodevelopmental outcomes at 24 months.-
dc.language.isoenen
dc.relation.urlhttp://pediatrics.aappublications.org/content/124/3/e459.full.pdf+htmlen
dc.subject.meshChild Development-
dc.subject.meshElectroencephalography-
dc.subject.meshFemale-
dc.subject.meshFollow-Up Studies-
dc.subject.meshHumans-
dc.subject.meshHypoxia-Ischemia, Brain-
dc.subject.meshInfant, Newborn-
dc.subject.meshMale-
dc.subject.meshPredictive Value of Tests-
dc.subject.meshProspective Studies-
dc.subject.meshTime Factors-
dc.titleEarly EEG findings in hypoxic-ischemic encephalopathy predict outcomes at 2 years.en
dc.typeArticleen
dc.contributor.departmentDepartment of Paediatrics and Child Health, University College Cork, Cork, Ireland. d.murray@ucc.ieen
dc.identifier.journalPediatricsen
dc.description.provinceMunster-

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