PERIOPERATIVE ELECTROENCEPHALOGRAPHIC SEIZURES IN INFANTS UNDERGOING REPAIR OF COMPLEX CONGENITAL CARDIAC DEFECTS

Many infants with cardiac anomalies undergo repair early in life. Both commonly used support techniques, deep hypothermic circulatory arrest (DHCA) and low-flow cardiopulmonary bypass (LFB), may be associated w ith adverse neurological outcomes, including seizures. In a single cen ter study, 171 infants undergoing correction for D-transposition of th e great arteries were randomized to one of these support techniques. I ncidence and onset times of EEG seizures during continuous EEG-video m onitoring in the first 48 h postoperatively and clinical seizures in t he first postoperative week were compared. EEG seizures were character ized by time, duration, and localization of onset. Incidence of EEG se izures (20%) was more than 3 times that of clinical seizures (6%): Mos t infants with EEG seizures had multiple seizures beginning between 13 and 36 h postoperatively. Durations ranged from 6 s to 980 min. Onset of EEG seizures occurred most commonly in frontal and central regions . Factors associated with EEG seizures included randomization to DHCA, longer duration of circulatory arrest, and diagnosis of VSD, In this study EEG seizures were common following this type of cardiac surgery, illustrating the importance of EEG monitoring in detecting seizures, This data adds insight into mechanisms of seizures in infants undergoi ng cardiac surgery. (C) 1997 Elsevier Science Ireland Ltd.