Early postnatal EEG features of perinatal arterial ischaemic stroke with seizures

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dc.contributor.authorLow, Evonne
dc.contributor.authorMathieson, Sean R.
dc.contributor.authorStevenson, Nathan J.
dc.contributor.authorLivingstone, Vicki
dc.contributor.authorRyan, C. Anthony
dc.contributor.authorBogue, Conor O.
dc.contributor.authorRennie, Janet M.
dc.contributor.authorBoylan, Geraldine B.
dc.contributor.funderWellcome Trust, United Kingdom
dc.contributor.funderScience Foundation Ireland
dc.contributor.funderNational Institute for Health Research, United Kingdom
dc.contributor.funderBiomedical Research Centre, Oxford
dc.date.accessioned2016-02-17T11:43:39Z
dc.date.available2016-02-17T11:43:39Z
dc.date.issued2014
dc.description.abstractBackground: 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.sponsorshipWellcome Trust, United Kingdom (Translational Award UK 85249/z/08/z); Science Foundation Ireland (Principal Investigator Award 10/IN.1/B3036)en
dc.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide100973
dc.identifier.citationLow 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.doi10.1371/journal.pone.0100973
dc.identifier.issn1932-6203
dc.identifier.issued7en
dc.identifier.journaltitlePLOS ONEen
dc.identifier.urihttps://hdl.handle.net/10468/2332
dc.identifier.volume9en
dc.language.isoenen
dc.publisherPublic Library of Scienceen
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 crediteden
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectNeonatal cerebral infarctionen
dc.subjectFull-term infantsen
dc.subjectPredictive valueen
dc.subjectVideo-EEGen
dc.subjectEncephalopathyen
dc.subjectElectroencephalogramen
dc.subjectEpilepsyen
dc.subjectNewbornen
dc.subjectBurdenen
dc.titleEarly postnatal EEG features of perinatal arterial ischaemic stroke with seizuresen
dc.typeArticle (peer-reviewed)en
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