Electroencephalogram And Prognosis Of Neonatal Seizures After Hypoxic-ischemic Encephalopathy

Objective: According to children with NBNA score and GDS follow-up results,analysis for the first time after birth aEEG monitoring results,MRI examination and serological monitoring results in the early diagnosis and prediction prognosis of NS after full-term neonatal HIE.Methods: aEEG monitoring was performed on 128 full-term neonates diagnosed with asphyxia in NICU of a third-grade a general hospital and selected 60 patients who were subsequently diagnosed with HIE and with clinical seizures or aEEG monitoring with convulsive wave issued.All subjects underwent A neurological examination,relevant serological examination and MRI examination.Subjects can be divided into normal aEEG group,mild abnormal aEEG group and severe abnormal aEEG group according to the results of the first postnatal aEEG monitoring.45 cases were successfully followed up for 28 weeks.Through follow-up results,the prognosis of children with NS after HIE could be divided into three groups: good prognosis,poor prognosis and poor prognosis.To analyze the early diagnosis and prognostic value of the first post-natal aEEG monitoring results for neonatal with NS after HIE.Result:(1)The results of aEEG monitoring and related clinical data in the early diagnosis of neonatal with NS after HIE: Among the clinical manifestations of 60 cases: mild abnormality group(12 cases),moderate abnormality group(32 cases)and severe abnormality group(16 cases).Compared with the three groups,there were significant differences in the results of aEEG monitoring for the first time after birth,MRI score,1 minutes Apgar score,PH value,lactic acid value and CK-MB in blood gas analysis within 2h after birth(P<0.05).The degree of aEEG abnormality was significantly correlated with the severity of the disease(r=0.633,P<0.001).The ROC curve analysis of the diagnostic value of aEEG monitoring results for nenatal with NS after HIE showed that the area under the ROC curve(AUC)was 0.716(P<0.05).The results of the first postnatal aEEG monitoring are of diagnostic significance for the severity of the disease in neonatal with NS after HIE.(2)Results of the first postnatal aEEG monitoring to predict the prognosis of neonatal with NS after HIE: Of 60 NS after HIE cases,9 cases were died,6 cases were lost to follow-up and 30 cases were followed up at 28 weeks old.Including 13 cases with good prognosis,23 cases with poor prognosis and 9 cases with worse prognosis.According to the prognosis,the clinical data of the three groups were statistically analyzed.At 28 weeks,there were significant differences in DQ scores in the normal aEEG group,the mild abnormal aEEG group,and the severe abnormal aEEG group(P<0.001).DQ value of severe abnormal aEEG group was significantly lower than that of normal aEEG group and mild abnormal aEEG group.The correlation analysis between the first aEEG monitoring and DQ at 28 weeks in neonatal with NS after HIE showed a statistical correlation between the degree of aEEG abnormality and the prognosis of neonatal with NS after HIE(r=0.792,P<0.001).The ROC curve of the prognosis of neonatal with NS after HIE can be evaluated by the first aEEG monitoring results after birth,and the AUC was 0.834(P<0.05).The first postnatal aEEG monitoring results can predict the early prognosis of neonatal with NS after HIE.All the 9 children died of severe abnormal aEEG background activity.Neonates with severe abnormal aEEG monitoring results after neonatal delivery are more likely to leave neurological sequelae.Conclusion:(1)aEEG monitored background activity for the first time after birth and related examinations are closely related to the disease severity.aEEG monitoring and related examinations can quickly and effectively determine the occurrence of NS after HIE in full-term infants.aEEG monitoring results have a good correlation with the severity of disease of neonatal with NS after HIE,and the full-term HIE neonatal need early aEEG monitoring in order to early diagnose the occurrence of NS and timely treatment to reduce brain injury.(2)The results of the first postnatal aEEG monitoring can be used to predict the short-term prognosis of neonatal with NS after HIE.Severe abnormal aEEG monitoring results in the first postnatal aEEG monitoring in full term neonatal with NS after HIE suggest poor prognosis.The first postnatal aEEG monitoring has certain clinical value in the prognosis evaluation of neonatal with NS after HIE.