Small Portable Unit Monitors Seizures in Neonates

These units could assist physicians in monitoring for electrical seizures before confirmation by conventional electroencephalography (EEG).

Seizures are episodes of abnormal brain activity that may or may not include involuntary muscle movements. Therefore, a seizure might be missed without the use of an EEG device. In newborns, seizures can indicate that something is wrong in the brain, which can result from a metabolic disorder such as a compromised blood supply to the brain before or during birth.

The new portable units are called amplitude-integrated EEG (aEEG) monitors. They use only two or four scalp electrodes to detect the brain's electrical activity, instead of the 12 or 20 used with conventional EEG devices. They also filter and compress the raw signals from the electrodes to provide simpler, shorter readouts than conventional EEG monitors. Amplitude-integrated EEG machines are easier for staff to manage, and the monitors can be run for longer periods more easily. They are less expensive to buy and operate than currently used monitors and more medical facilities will be able to afford them.

Washington University School of Medicine in St. Louis (MO, USA) investigators compared the aEEG with conventional EEG. They used both technologies simultaneously for an average of 18 hours per patient to monitor the brain activity of 21 newborns who had experienced seizures. They also compared three different aEEG setups.

"We found that we could pick up seizure activity in most of the patients using aEEG monitors that included raw signals,” said Divyen Shah, M.D., a clinical fellow in the university division of newborn medicine. "In most medical centers worldwide, conventional EEG isn't available because it's expensive and resource intensive. We [have] shown that when staff members have training in interpreting aEEG, it can be effective for monitoring electrical seizure activity in newborns.”

The scientific team, headed by senior author Terrie E. Inder, M.D., associate professor of pediatrics and a Washington University pediatrician at St. Louis Children's Hospital, intends to use aEEG as a tool in a trial of medications for seizures in newborns. They will use different treatment options to determine the optimal therapy for these patients.

The study was reported in the June 2008, issue of the journal Pediatrics.


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Washington University School of Medicine in St. Louis