Evolution Of EEG Background Related To The Severity Of Brain Injury In Neonatal Hypoxic-ischemic Encephalopathy

Objective:To investigate the correlation between the evolution of EEG background and brain injury in neonatal hypoxic-ischemic encephalopathy(HIE).Methods:A retrospective study was conducted on the neonates with HIE in the Shengjing Hospital Affiliated to China Medical University between January 2016 and January 2021.Clinical grading was performed according to the modified Sarnat scoring standard.And the EEG background at different time was evaluated using the American Clinical Neurophysiology Society’s Guideline on Continuous Electroencephalography Monitoring in Neonates.The modified MRI scoring system was used to determine the injury scores on different MRI sequences.The relationship between the EEG background grading and the brain injury was analyzed.Results:A total of 56 patients were included: 1.Neonates with mild HIE or MRI without brain injury and W injury may have moderate to severe abnormalities in early EEG background.But they can be improved in a short time.The early EEG of patients with moderate HIE or MRI with BG/T+BS injury was mainly moderate and severe,and all improved to mild after 7 days.Almost all patients with severe HIE or global brain injury had severe EEG background after birth,and some of them even lasted until 7 days later.2.EEG can nicely predict the severity of brain injury(r=0.751,P<0.001)and theshort-term outcome(AUC=0.825,sensitivity=100%,specificity=61.9%)in HIE neonates between 48 and 72 hours postnatal.3.Follow-up of individual cases showed that early EEG background in neonates with moderate HIE and W injury HIE may be severely abnormal,which can be improved in a short time.However,EEG background may improve slowly in patients with severe HIE and BG/T+BS injury.And neurological sequelae such as infantile spasm may be left.Conclusion: The evolution of EEG background in HIE patients has certain rules.And its grading is well correlated with clinical grading,MRI score and short-term outcome,which is helpful for the assessment of brain injury in HIE and plays an important role in the prognosis assessment.