Characteristics Of Amplitude Integrated Electroencephalogram In Full-term Brain-injured Neonates With Subclinical Seizures

ObjectiveTo explore the record continuity of background activity,awakening cycle,lower boundary amplitude of amplitude integrated electroencephalogram(a EEG)in full-term brain-injured neonates with subclinical seizures.Through this study,we can further understand the characteristics of a EEG in subclinical seizures.Pay attention to the harm of subclinical seizures,provide basis for early diagnosis of subclinical seizures,and reduce the neurological sequelae of pediatric patients.MethodsA total of 62 full-term neonates with cerebral injuries who were admitted to the neonatal intensive care unit from November 2016 to February 2018 in the Affiliated Hospital of Yan ’ an University were selected.According to the presence or absence of clinical manifestations and electrical seizures in neonates with brain injuries,they were divided into clinical group(group B),clinical-electrical group(group C),and subclinical group(group D).At the same time,20 cases of full-term neonates without brain injury were selected as the control group(group A).a EEG monitoring was performed within 6hours after admission,more than 12 hours of continuous monitoring.All children with brain MRI(magnetic resonance imaging,MRI)on 3 to 5 days.The brain electrophysiological changes such as the continuity of background activity,SWC,and amplitude of the lower boundary were analyzed.The a EEG index of each group was analyzed.Result1.The overall distribution of background activity in each groups were statistically significant(P<0.05),there was a significant difference;the overall distribution of background activity in clinical-electrical group and subclinical group was not statisticallysignificant.(P>0.0083);the overall distribution of background activity between the other groups was statistically significant;especially,the overall distribution of background activity between subclinical group and clinical group,subclinical group and control group were statistically significant(P<0.0083).2.The overall distribution of SWC in each groups were statistically significant(P<0.05);the distribution of clinical-electrical group and subclinical group was not statistically significant(P>0.0083);the overall distribution of SWC between the other groups was statistically significant;obviously,among them,the difference in SWC distribution between subclinical group and control group,subclinical group and clinical group was statistically significant(P<0.0083).3.The mean value of the amplitude of the lower boundary of the background waves in each groups were statistically significant(P<0.05),and there was an obviously difference;there was no significant difference in the average amplitude of the lower boundary between the clinical-electrical group and the subclinical group(P>0.0083);the mean amplitude of the lower boundary between the other groups was significant(P<0.0083).It was worth noting that the mean amplitude of the lower border between the subclinical group and the control group,the subclinical group and the clinical group was statistically significant(P <0.0083),there was a markedly difference.4.The overall distribution of a EEG index in each groups were statistically significant(P<0.05),and there was a significant difference.there was no significant difference between the clinical-electrical group and the subclinical group(P>0.0083);the a EEG index between the other groups was significant(P<0.0083).It can be clearly observed that the difference in a EEG index between subclinical group and control group,subclinical group and clinical group were significantly different(P<0.0083).Conclusion1.Background activity,SWC and seizure types are related.The continuation of background activity in neonates with subclinical seizures was significantly worse than those in non-brain injury and clinical seizure.Similarly,SWC in subclinical groups were more immature than those in non-brain-injured and clinical groups,even without SWC.2.The amplitude of the lower boundary has a correlation with the seizure type.The lower border amplitude(lowest voltage)was significantly lower in subclinical groups,which was lower than the lowest voltage in neonates with non-brain injury and clinical seizure groups.3.The a EEG classification result has a correlation with seizure types.Compa red with non-brain-injured and clinical seizure groups,a EEG results were abnorma l in subclinical children.4.Although subclinical seizures in neonates without clearly clinical manifestat ions,a EEG records often show abnormal changes in background activity,SWC,a nd lower border amplitude.It is suggested that a EEG examination should be used as one of the routine monitoring for neonates with brain injury.Early detection and treatment of such patients should be done to improve the prognosis of the n ervous system.