A RELIABILITY STUDY OF A NEONATAL SEIZURE SCORING SYSTEM

Two measures of reliability assessed inter-rater agreement regarding n eonatal seizure scoring: coefficient of variation and intraclass corre lation coefficient. Ten neonates with electrographic seizures recorded during each of 2 h of an EEG-sleep study were submitted for visual an alysis. The onset, spread, and termination of seizures were coded. The number of anatomical sites with electrographic seizures as well as th e durations for each of three phases of the seizure were calculated. S even EEG scores for these 10 patients were coded independently by thre e different raters. The number of sites at the onset of each seizure a nd the duration of seizures, both at the onset and for the entire dura tion of the seizure, had moderate-to-excellent reliability. Lower reli ability, however, was noted for the number of seizures during the phas es of spread and termination. Before the development of computerized p rograms to detect and document the evolution of neonatal seizures, par ticularly in the context of treatment with different medications, prac tical strategies based on visual analysis need to be developed. Althou gh the onset and total duration of seizures can be reliably scored amo ng raters, the more variable description of spread and termination of the seizure is more problematic and requires greater attention and exp erience. This technique may be useful in evaluating the medication eff icacy.