Irish Child Health Database - Peer Reviewed Papers
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Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures
Published in:
Arch Dis Child Fetal Neonatal Ed, Vol: 93, Page: F187-91
Publication Date:
May 2008
Aims & Objectives:
This study aimed to explore the clinical manifestations of electrographic seizures recorded on continuous video-EEG, and to compare this description with the recognition of clinical seizures by experienced neonatal staff
Abstract:
BACKGROUND: Neonatal seizures are often subclinical, making accurate diagnosis difficult. OBJECTIVE: To describe the clinical manifestations of electrographic seizures recorded on continuous video-EEG, and to compare this description with the recognition of clinical seizures by experienced neonatal staff. METHODS: Term infants, at risk of seizures, were monitored by continuous 12-channel video-EEG from <6 hours of birth for up to 72 hours. All clinical seizures were recorded by experienced neonatal staff on individual seizure charts. Video-EEG recordings were subsequently analysed. The number, duration and clinical expression of electrographic seizures were calculated (in seconds), and compared with the seizures clinically suspected by the neonatal staff. RESULTS: Of 51 infants enrolled, nine had electrographic seizures. A further three had clinically suspected seizures, without associated electrographic abnormality. Of the total 526 electrographic seizures, 179 (34%) had clinical manifestations evident on the simultaneous video recording. The clinical seizure activity corresponded to 18.8% of the total electrographic seizure burden. Overdiagnosis also occurred frequently. Of the 177 clinically suspected seizure episodes documented by staff, 48 (27%) had corresponding electrographic evidence of seizure activity Thus, only 9% (48/526) of electrographic seizures were accompanied by clinical manifestations, which were identified and documented by neonatal staff. CONCLUSION: Only one-third of neonatal EEG seizures displays clinical signs on simultaneous video recordings. Moreover, two-thirds of these clinical manifestations are unrecognised, or misinterpreted by experienced neonatal staff. In the recognition and management of neonatal seizures clinical diagnosis alone is not enough.
Authors:
Study Type:
Study Papers » Study assessing the practice and/or knowledge of targeted professional or parent » Descriptive Studies - Measuring aspects of effectiveness
Categories:
neonatal electrographic seizures
International Classification:
Practice/knowledge - Neonatal seizures
Keywords:
- Clinical Competence
- Electroencephalography/methods
- Female
- Humans
- Infant, Newborn
- Intensive Care, Neonatal
- Ireland
- Male
- Medical Staff, Hospital
- Monitoring, Physiologic/methods
- Nursing Staff, Hospital
- Retrospective Studies
- Seizures/ diagnosis
- Video Recording
Geography:
Republic of Ireland (Cork)