Electroencephalography in neonatology

Authors

  • Nada Sindičić Dessardo Zavod za neonatologiju i neonatalnu intenzivnu medicinu Referentni centar Ministarstva zdravstva za pedijatrijsku i neonatalnu intenzivnu medicinu Klinika za pedijatriju KBC Zagreb

DOI:

https://doi.org/10.13112/pc.1192

Keywords:

Infant, Newborn; Electroencephalography; Hypoxia-Ischemia, Brain; Epilepsies, Partial; Seizures.

Abstract

Electroencephalography (EEG) represents an irreplaceable neurophysiological method in contemporary neonatal medicine. The combination of continuous video-EEG monitoring (cvEEG) and amplitude-integrated EEG (aEEG) enables timely detection of subclinical seizures, objective assessment of brain function recovery, and risk stratification in neonates with encephalopathy. The International League Against Epilepsy (ILAE) classification of neonatal seizures, along with the publication of the American Clinical Neurophysiology Society (ACNS) expert guidelines for the application and interpretation of encephalography, has placed EEG at the center of the diagnostic process and enabled the standardization of clinical practice.

References

1. Shellhaas RA, Chang T, Tsuchida T, Scher MS, Riviello JJ, Abend NS, et al. The American clinical neurophysiology society’s guideline on continuous electroencephalography monitoring in neonates. J Clin Neurophysiol. 2011;28:611–7.

2. Volpe JJ. Volpe’s Neurology of the Newborn. 6th ed. Philadelphia: Elsevier; 2018.

3. Tsuchida TN, Wusthoff CJ, Shellhaas RA, Abend NS, Hahn CD, Sullivan JE, et al. American clinical neurophysiology society standardized EEG terminology and categorization for the description of continuous EEG monitoring in neonates: report of the American Clinical Neurophysiology Society critical care monitoring committee: Report of the American clinical neurophysiology society critical care monitoring committee. J Clin Neurophysiol. 2013;30:161–73

4. Toet MC, Hellström-Westas L, Groenendaal F, Eken P, de Vries LS. Amplitude integrated EEG 3 and 6 hours after birth in full term neonates with hypoxic-ischaemic encephalopathy. Arch Dis Child Fetal Neonatal Ed. 1999;81:F19-23.

5. Pressler RM, Cilio MR, Mizrahi EM, Moshé SL, Nunes ML, Plouin P, et al. The ILAE classification of seizures and the epilepsies: Modification for seizures in the neonate. Position paper by the ILAE Task Force on Neonatal Seizures. Epilepsia. 2021;62:615–28.

6. de Vries LS, Hellström-Westas L. Role of cerebral function monitoring in the newborn. Arch Dis Child Fetal Neonatal Ed. 2005;90:F201-7.

7. Hellström-Westas L, Rosén I, de Vries LS, Greisen G. Amplitude-integrated EEG Classification and Interpretation in Preterm and Term Infants. NeoReviews. 2006;7:e76-e87.

8. El-Dib M, Massaro AN, Glass P, Aly H. Neurobehavioral assessment as a predictor of neurodevelopmental outcome in preterm infants. J Perinatol. 2012;32:299-303.

9. Hellström-Westas L, de Vries LS, Rosen I. An Atlas of Amplitude-integrated EEGs in the Newborn. 2nd ed. London: Informa Healthcare; 2008.

10. Shellhaas RA, Soaita AI, Clancy RR. Sensitivity of amplitude-integrated electroencephalography for neonatal seizure detection. Pediatrics. 2007;120:770-7.

11. Shah DK, Wusthoff CJ, Sullivan J, Bartko AM, Kirsch R, Rycus P, et al. Screening for seizures with amplitude-integrated EEG in neonates treated with extracorporeal membrane oxygenation. Pediatrics. 2016;138:e20161422.

12. Glass HC, Wusthoff CJ, Shellhaas RA, Tsuchida TN, Bonifacio SL, Cordeiro M, et al. Risk factors for EEG seizures in neonates treated with hypothermia: a multicenter cohort study. Neurology. 2014;82:1239–44.

13. Shellhaas RA, Wusthoff CJ, Tsuchida TN, Glass HC, Chu CJ, Massey SL, et al. Profile of neonatal epilepsies: Characteristics of a prospective US cohort. Neurology. 2017;89:893–9.

14. Painter MJ, Scher MS, Stein AD, Armatti S, Wang Z, Gardiner JC, wt al. Phenobarbital compared with phenytoin for the treatment of neonatal seizures. N Engl J Med. 1999;341:485-9.

15. Murray DM, Boylan GB, Ali I, Ryan CA, Murphy BP, Connolly S. Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures. Arch Dis Child Fetal Neonatal Ed. 2008;93:F187-91.

16. Clancy RR, Legido A, Lewis D. Occult neonatal seizures. Epilepsia. 1988;29:256-61.

17. Mizrahi EM, Kellaway P. Characterization and classification of neonatal seizures. Neurology. 1987;37:1837-44.

18. Hellström-Westas L, de Vries LS, Rosen I. An Atlas of Amplitude-integrated EEGs in the Newborn. CRC Press; 2006.

19. Boylan GB, Pressler RM, Rennie JM, Morton M, Leow PL, Hughes R, et al. Outcome of electroclinical, electrographic, and clinical seizures in the newborn infant. Dev Med Child Neurol. 1999;41:819–25.

20. Kharoshankaya L, Stevenson NJ, Livingstone V, Murray DM, Murphy BP, Ahearne CE, et al. Seizure burden and neurodevelopmental outcome in neonates with hypoxic–ischemic encephalopathy. Dev Med Child Neurol. 2016;58:1242–8.

21. Glass HC, Shellhaas RA, Wusthoff CJ, Chang T, Abend NS, Chu CJ, et al. Contemporary profile of seizures in neonates: A prospective cohort study. J Pediatr. 2016;174:98-103.e1.

22. Thoresen M, Hellström-Westas L, Liu X, de Vries LS. Effect of hypothermia on amplitude-integrated electroencephalogram in infants with asphyxia. Pediatric. 2010;126:e131-9.

23. Glass HC, Glidden D, Jeremy RJ, Barkovich AJ, Ferriero DM, Miller SP. Clinical neonatal seizures are independently associated with outcome in infants at risk for hypoxic-ischemic brain injury. J Pediatr. 2009;155:318–23.

24. Scher MS, Alvin J, Gaus L, Minnigh B, Painter MJ. Uncoupling of EEG-clinical neonatal seizures after antiepileptic drug use. Pediatr Neurol. 2003;28:277–80.

25. al Naqeeb N, Edwards AD, Cowan FM, Azzopardi D. Assessment of neonatal encephalopathy by amplitude-integrated EEG. Arch Dis Child Fetal Neonatal Ed. 1999;80:F110-6.

26. Chandrasekaran M, Chaban B, Montaldo P, Thayyil S. Predictive value of amplitude-integrated EEG (aEEG) after rescue hypothermic neuroprotection for hypoxic ischemic encephalopathy: a meta-analysis. J Perinatol. 2017;37:684-9.

27. Hellström-Westas L, Rosén I, de Vries LS. Cerebral function monitoring with amplitude-integrated EEG in newborn infants. Curr Opin Pediatr. 2009;21:159-64.

28. Lloyd RO, O’Toole JM, Pavlidis E, Filan PM, Boylan GB. Electrographic seizures during the early postnatal period in preterm infants. J Pediatr. 2017;187:18-25.e2.

29. Andropoulos DB, Mizrahi EM, Hrachovy RA, Stayer SA, Stark AR, Heinle JS, et al. Electroencephalographic seizures after neonatal cardiac surgery with high-flow cardiopulmonary bypass. Anesth Analg. 2010;110:1680–5.

30. Lin J-J, Banwell BL, Berg RA, Dlugos DJ, Ichord RN, Kilbaugh TJ, et al. Electrographic seizures in children and neonates undergoing extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2017;18:249–57.

31. Latal B, Wohlrab G, Brotschi B, Beck I, Knirsch W, Bernet V. Postoperative amplitude-integrated electroencephalography predicts four-year neurodevelopmental outcome in children with complex congenital heart disease. J Pediatr. 2016;178:55-60.e1.

32. Kirschen MP, Vossough A, Donegan RK, Graham K, Zuppa AF, Licht DJ, et al. Neurologic monitoring and complexity of care in pediatric extracorporeal membrane oxygenation. Pediatr Crit Care Med. 2019;20:926-35.

33. Pavel AM, Rennie JM, de Vries LS, Blennow M, Foran A, Shah DK, et al. Neonatal seizure management: Is the timing of treatment critical? J Pediatr. 2022;243:61-68.e2.

34. Pisani F, Facini C, Pavlidis E, Spagnoli C, Boylan G. Epilepsy after neonatal seizures: literature review. Eur J Paediatr Neurol. 2015;19:6–14.

Published

2026-04-03

How to Cite

Sindičić Dessardo, N. (2026). Electroencephalography in neonatology. Paediatria Croatica, 70(suppl 3), 233-44. https://doi.org/10.13112/pc.1192

Similar Articles

1-10 of 256

You may also start an advanced similarity search for this article.