The Value Of Video Electroencephalogram Monitoring In Neonatal Seizures

Objective To evaluate the value of Video electroencephalogram(VEEG) in neonatal seizure. According to Video Electroencephalographic monitoring recorded and marked the clinical signs and EEG at the same time, to evaluate the clinical significance of Video-EEG monitoring in the differential diagnosis of epileptic seizures(ES) and non-epileptic seizures(NES), and the value in ictal and interictal EEG type of ES. To evaluate the practical value of Video-EEG in prognosis of neonatal seizures.Methods 64 infants diagnosed as neonatal seizure clinically, were monitored with Video-EEG instrument (WEISI VEEG1161B) for 4~6h at awake or sleep states until seizure or eleptiform activity was recorded, the hours of sleep including a complete sleep cycle at least. The clinical signs and EEGs were recorded and marked at the same time. Afterwards, both were analyzed digitally.Results Incidence of abnormal VEEG is 87.5%. Among sixty-four cases found in the VEEG thirteen cases showed epileptic discharge in the ictal VEEGs; three cases showed epileptic discharge in the interictal VEEGs, but they have normal background rhythm; two cases have epileptic discharge in the interictal VEEGs with abnormal background rhythm; the other abnormal EEGs included five case of hypoactive, 24 case of immature EEGs, 5 case of double latus dissymmetry >50%, 2 case of burst suppression and 2 case of electrical silence.1. Discharges occurred more frequency in sleeping than in wakefulness. mostly happening in the quiet sleep phase.2. A closer correlation exists between neonatal seizures EEGs and etiology. Theepileptic discharges in brain structural disease are most common. Most of ictal epilepticdischarges had a focal onset(16/18), which are in the temple lobe in 13 cases.3.The result shows that the clinical events may not associate with the associatesynchronous EEG epileptiform activity; and that the EEG recording may be stillnormal during epileptic seizure, but epileptiform EEG discharges may be recorded inthose with nonepileptic seizure.In addition, Epileptic and nonepileptic seizures maycoexist. So comprehesive analysis of the clinical manifestation and EEG chargescombined with illness history and EEG findings should be made when considering toneonatal seizures. 40 cases who had no epileptic discharges in the ictal and interictalVEEGs were guaranted non-epileptic seizures.4.A closer correlation exist between neonatal seizures' prognosis and seizure types,the number of seizure times and seizure duration.5.There is significant difference between incidence of sequelae in normal or mildabnormal EEGs and severe abnormal EEGs..6. The presence of a burst-suppression EEG pattern, epileptic discharge, hypoactiveand even flat EEG is negative prognostic criteria. The prognosis is also related to thebackground activity of EEGs.Conlusion1. VEEG has important values for the diagnosis and differential diagnosis in neonatal seizures.2. Neonatal video electroencephalographic monitoring is one of useful and convenient means to evaluate prognosis.