Early postnatal EEG features of perinatal arterial ischaemic stroke with seizures

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dc.contributor.author Low, Evonne
dc.contributor.author Mathieson, Sean R.
dc.contributor.author Stevenson, Nathan J.
dc.contributor.author Livingstone, Vicki
dc.contributor.author Ryan, C. Anthony
dc.contributor.author Bogue, Conor O.
dc.contributor.author Rennie, Janet M.
dc.contributor.author Boylan, Geraldine B.
dc.date.accessioned 2016-02-17T11:43:39Z
dc.date.available 2016-02-17T11:43:39Z
dc.date.issued 2014
dc.identifier.citation Low E, Mathieson SR, Stevenson NJ, Livingstone V, Ryan CA, Bogue CO, et al. (2014) Early Postnatal EEG Features of Perinatal Arterial Ischaemic Stroke with Seizures. PLoS ONE 9(7): e100973. doi:10.1371/journal.pone.0100973
dc.identifier.volume 9 en
dc.identifier.issued 7 en
dc.identifier.issn 1932-6203
dc.identifier.uri http://hdl.handle.net/10468/2332
dc.identifier.doi 10.1371/journal.pone.0100973
dc.description.abstract Background: Stroke is the second most common cause of seizures in term neonates and is associated with abnormal long-term neurodevelopmental outcome in some cases. Objective: To aid diagnosis earlier in the postnatal period, our aim was to describe the characteristic EEG patterns in term neonates with perinatal arterial ischaemic stroke (PAIS) seizures. Design: Retrospective observational study. Patients: Neonates >37 weeks born between 2003 and 2011 in two hospitals. Method: Continuous multichannel video-EEG was used to analyze the background patterns and characteristics of seizures. Each EEG was assessed for continuity, symmetry, characteristic features and sleep cycling; morphology of electrographic seizures was also examined. Each seizure was categorized as electrographic-only or electroclinical; the percentage of seizure events for each seizure type was also summarized. Results: Nine neonates with PAIS seizures and EEG monitoring were identified. While EEG continuity was present in all cases, the background pattern showed suppression over the infarcted side; this was quite marked (>50% amplitude reduction) when the lesion was large. Characteristic unilateral bursts of theta activity with sharp or spike waves intermixed were seen in all cases. Sleep cycling was generally present but was more disturbed over the infarcted side. Seizures demonstrated a characteristic pattern; focal sharp waves/spike-polyspikes were seen at frequency of 1-2 Hz and phase reversal over the central region was common. Electrographic-only seizure events were more frequent compared to electroclinical seizure events (78 vs 22%). Conclusions: Focal electrographic and electroclinical seizures with ipsilateral suppression of the background activity and focal sharp waves are strong indicators of PAIS. Approximately 80% of seizure events were the result of clinically unsuspected seizures in neonates with PAIS. Prolonged and continuous multichannel video-EEG monitoring is advocated for adequate seizure surveillance. en
dc.description.sponsorship Wellcome Trust, United Kingdom (Translational Award UK 85249/z/08/z); Science Foundation Ireland (Principal Investigator Award 10/IN.1/B3036) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Public Library of Science en
dc.rights © 2015 Low et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited en
dc.rights.uri http://creativecommons.org/licenses/by/4.0/ en
dc.subject Neonatal cerebral infarction en
dc.subject Full-term infants en
dc.subject Predictive value en
dc.subject Video-EEG en
dc.subject Encephalopathy en
dc.subject Electroencephalogram en
dc.subject Epilepsy en
dc.subject Newborn en
dc.subject Burden en
dc.title Early postnatal EEG features of perinatal arterial ischaemic stroke with seizures en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Geraldine Boylan, Department of Paediatrics and Child Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: g.boylan@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.internal.rssid 271356167
dc.internal.rssid 271356167
dc.internal.wokid WOS:000339551100006
dc.contributor.funder Wellcome Trust, United Kingdom
dc.contributor.funder Science Foundation Ireland
dc.contributor.funder National Institute for Health Research, United Kingdom
dc.contributor.funder Biomedical Research Centre, Oxford
dc.description.status Peer reviewed en
dc.identifier.journaltitle PLOS ONE en
dc.internal.IRISemailaddress g.boylan@ucc.ie en
dc.identifier.articleid e100973


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© 2015 Low et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited Except where otherwise noted, this item's license is described as © 2015 Low et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
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