PROGNOSTIC VALUE OF CONTINUOUS ELECTROENCEPHALOGRAPHIC RECORDING IN FULL-TERM INFANTS WITH HYPOXIC-ISCHEMIC ENCEPHALOPATHY

The prognostic value of early neonatal continuous electroencephalograp hic recordings in hypoxic ischaemic encephalopathy was evaluated. Thir ty seven full term infants with hypoxic ischaemic encephalopathy were studied. The electroencephalogram (EEG) was recorded using four or eig ht channel Oxford Medilog recorders and was started as soon as possibl e after birth. The recordings were initially visually analysed and div ided into four categories: three in relation to the grade of discontin uity of the background activity (continuous, discontinuous, and maximu m depression) and an additional fourth category to include status epil epticus. The EEGs with discontinuous activity were then analysed by co mputer to obtain a more objective assessment of discontinuity. The res ults were related to neurological outcome. Continuous background activ ity was associated with a normal outcome in all but the three infants who had continuous, but asymmetrical EEGs and who developed contralate ral hemiplegia. In the eight infants with discontinuous activity, the outcome appeared to be related to the grade of continuity and the pres ence of clear convulsions on the EEG. The 10 infants with maximum depr ession and status epilepticus had severe impairment. These preliminary results suggest that continuous recording of EEGs could be used routi nely in term infants with hypoxic ischaemic encephalopathy. Computer a nalysis can improve the value of this technique, allowing the identifi cation of infants who might benefit from early therapeutic interventio n.