EEG and long-term outcome of term infants with neonatal hypoxic-ischemic encephalopathy

Objective: The prognostic value of a burst suppression pattern (BSP) on the electraencephalograph (EEG) in the prediction of long-term outcome for ful l term newborns with hypoxic-ischemic encephalopathy (HIE) is well establis hed. The purpose of our study was to compare the patterns of burst suppress ion on EEG with long-term neurological outcome in term infants with HIE. Methods: We retrospectively analyzed all records of all full-term newborn i nfants born at the University of Alberta Hospital between January 1, 1991 a nd December 31, 1992, who had clinical evidence of HIE and had at least one EEG during the first week of life. The EEGs were reviewed and blindly subc lassified into a BSP, or if the pattern was not continuous or was incomplet e, a modified burst suppression pattern (MBSP), based on specified electrop hysiological criteria. The long-term neurological outcome was then correlat ed with the EEG pattern. Results: Twenty-three full-term infants were studied. Fifteen had a BSP on EEG and 8 had a MBSP. Six of 15 infants with a BSP died. Of the 9 survivors with a BSP, 7 are disabled and two are normal. Of the 8 infants in the MBS P group, one infant died, two are disabled and 5 are normal. In the BSP gro up, 6/7 disabled infants developed cerebral palsy while in the MBSP group, only one developed cerebral palsy. Conclusion: The results are suggestive of a better outcome for infants with neonatal HIE and MBSP on EEG compared with those with a BSP. Subclassifica tion of the EEG changes of neonatal HIE into BSP and MBSP may give a more a ccurate prediction of outcome in perinatal asphyxia and assist in discussio n with parents about prognosis. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.