Affiliations: Department of Women's and Children's Health, Uppsala
University Hospital, Uppsala, Sweden | Department of Neonatology, Wilhelmina Children's'
Hospital, Utrecht, The Netherlands
Note: [] Correspondence: Dr. Lena Hellström-Westas, Department of
Women's and Children's Health, Uppsala University Hospital, SE-75185 Uppsala,
Sweden. E-mail: lena.westas@kbh.uu.se
Abstract: Introducing amplitude integrated electroencephalography in the
neonatal intensive care unit has made us aware of the common occurrence of
seizures in high risk newborn infants. Using this technique or conventional
multi-channel electroencephalography we now know that clinical seizures are
often not confirmed as seizure patterns on the amplitude integrated
electroencephalography, that subclinical seizures are very common in newborn
infants, especially after administration of a first antiepileptic drug, which
is called electroclinical dissociation or decoupling. A status epilepticus is
also not uncommon and is also usually entirely subclinical. We are well aware
that focal, low amplitude and very brief seizures will not be detected using
this technique. The amplitude integrated electroencephalography technology has
greatly been improved over the last decade, changing from analogue to digital
and from strictly one-channel to now mostly two channel recordings. The major
improvement is the simultaneous display of the raw electroencephalography and
in some machines even access to a seizure detection algorithm. These
developments have made it possible to find the best electrode placements and to
study the effects of antiepileptic drugs more effectively.
