早产儿颅内出血振幅整合脑电图背景模式及睡眠觉醒周期的特点

目的 分析不同程度脑室周围-脑室内出血（PIVH）早产儿振幅整合脑电图（aEEG）背景模式及睡眠觉醒周期的特点。方法 选取56 例胎龄25~33 周的PIVH 早产儿及31 例同胎龄段无PIVH 早产儿,将PIVH 患儿按Papile 分级标准分为轻度出血组（Ⅰ、Ⅱ级）和中重度出血组（Ⅲ、Ⅳ级）,对各组早产儿aEEG的结果进行比较分析。结果 与轻度出血组及对照组比较,中重度出血组患儿的电压连续性降低,睡眠觉醒周期（SWC）缺失率高,aEEG 评分低（P 结论 aEEG 背景活动及SWC 的改变与早产儿PIVH 的严重程度有关。     

Serum creatine kinase BB as predictor of periventricular haemorrhage in preterm infants

Serum creatine kinase BB (CK-BB) determinations were performed daily in 49 newborn infants of less than 34 weeks gestation to evaluate its usefulness in predicting the occurrence of periventricular-intraventricular haemorrhage (PIVH). Using ultrasound PIVH was detected in 20 infants (41%); five grade I, seven grade II, two grade III, six grade IV (grading according to Papile et al.). Infants who developed severe PIVH (grade IV) during the study period had significantly higher serum CK-BB activities immediately after birth when compared with infants who developed less severe haemorrhages (grades I, II and II) or no PIVH. We postulate that these high serum enzyme activities are caused by perinatal brain cell damage which is an important antecedent of severe PIVH. Therefore, serum CK-BB activities at birth can be used as predictor of severe PIVH.     

Intra- and extrauterine maturation of amplitude-integrated electroencephalographic activity in preterm infants younger than 30 weeks of gestation

OBJECTIVE: To prospectively investigate the longitudinal changes of amplitude-integrated electroencephalographic (aEEG) activity in preterm infants <30 weeks gestational age (GA). METHODS: Infants (GA <30 weeks) without evidence of neurological abnormalities had weekly aEEG recordings performed. The relative duration of the three aEEG patterns (discontinuous low voltage, discontinuous high voltage and continuous) was determined and the influence of GA and postnatal age (PNA) on the occurrence of each pattern was assessed. RESULTS: Ninety-eight infants (median GA 26 weeks; range 23-29 weeks) were studied. With higher GA (OR 1.68, 95% CI 1.33-2.13) and PNA (OR 1.91, 95% CI 1.53-2.38), the likelihood for the occurrence of continuous activity increased. The discontinuous low-voltage pattern was less likely to occur with increasing GA (OR 0.68, 95% CI 0.55-0.83) and PNA (OR 0.70, 95% CI 0.61-0.81). CONCLUSION: Maturation of aEEG activity in preterm infants is influenced by both GA and PNA.     

Prognosis and evolution of bilateral grade III intraventricular - hemorhages (III-III-IVH)

OBJECTIVE: To describe the evolution of bilateral III IVH so as to define optimal dates for therapeutic moves.METHODS: Longitudinal study of brain ultrasound scans from day 1 over the first three months of life. Our team calls "massive III" a hemorrhage with an intraventricular clot diameter >8mm on the coronal view at the level of Monro's foramina of the day of maximal hemorrhage. The 90 neonates were divided into four groups. Group I included 29 premature neonates who died in the first seven days after birth (birthweight (BW), 1,114 -/+253 g, gestational age (GA), 28 weeks 3 days); with 21 massive uni/bilateral grade III PIVH, and early filling of the whole ventricular system and cisterna magna. Group II included seven premature neonates who died in the second week after birth (similar in BW and GA, but more heterogeneous group). Two groups of infants survived for more than 14 days. Group III included 30 premature neonates (BW, 1,299 -/+260 g, GA, 29 weeks 1 day), with 20 classical grade III PIVH, who had post-hemorrhagic dilatation regressed spontaneously in 13 cases and regressed after acetazolamide treatment in 17 cases (five deaths due to three bronchopulmonary dysplasias and two periventricular leucomalacias). Group IV included 24 premature neonates (BW, 1,344 -/+289 g, GA, 29 weeks 5 days) with 15 massive grade III PIVH, who suffered posthemorrhagic hydrocephalus through obstruction of the Sylvius aqueduct (15) and/or of the cisterna magna (21), 12 blocks affecting both levels. Blocks were observed from day 8, and 35 in the quasi totality of cases (17 deaths).CONCLUSIONS: From 1,183 consecutive peri-intraventricular hemorrhages (PIVH) diagnosed by brain ultrasound studies (01/01/81-12/31/94), 90 were grade (III-III) PIVH, with a 36% overall survival. The massive volume of grade III PIVG plays a heavy role in early deaths of extremely low birthweight neonates and it heralds a blocked hydrocephalus in more vigorous infants who survive PIVH.     

Cerebrospinal fluid drainage in posthaemorrhagic ventricular dilatation leads to improvement in amplitude-integrated electroencephalographic activity

Aim: Progressive posthaemorrhagic ventricular dilatation (PHVD) may induce abnormal amplitude-integrated electroencephalographic (aEEG) activity prior to clinical deterioration or significant cerebral ultrasound changes. These abnormalities might be ameliorated with cerebrospinal fluid (CSF) drainage. The aims of this study were to investigate the occurrence of aEEG-abnormalities with progressive PHVD in relation to clinical and cerebral ultrasound changes and to evaluate whether CSF drainage results in aEEG improvement.
Methods: aEEG and cerebral ultrasound scans were performed in 12 infants with PHVD, before and after CSF drainage, until normalization of aEEG occurred.
Results: aEEG was abnormal with progressive PHVD in all patients. Concurrently, 60% of the patients were clinically stable without deterioration in ultrasonographic cerebral abnormalities. Post drainage, continuous pattern was restored in all but one patient, whereas the frequency of discontinuous pattern decreased in nine patients and burst-suppression pattern decreased in all but one patient. Low-voltage pattern was only observed in one patient who suffered severe grade IV IVH and died one week after EVD placement. Sleep-wake cycling matured in 75%.
Conclusion: These findings demonstrate the impact of CSF drainage on compromised aEEG-activity associated with PHVD. aEEG changes indicative of impaired cerebral function were apparent before clinical deterioration or major ultrasound changes. These changes were reversible with CSF drainage. aEEG should therefore be used in addition to clinical observation and ultrasound when monitoring PHVD.     

Early abnormal amplitude-integrated electroencephalography (aEEG) is associated with adverse short-term outcome in premature infants

BackgroundIn preterm infants with IVH the electrocortical background activity is affected and there is a correlation between the severity of cerebral injury to the degree of depression, however the usefulness of the early aEEG recordings has hardly been determined.AimTo identify early aEEG features that could be used as prognostic markers for severe brain injury in prematures.MethodsIn 115 infants, 25–32 wk GA, aEEG recordings during the first 72 h of life were correlated with head ultrasound findings. Continuity (Co), sleep–wake cycling (Cy) and amplitude of the lower border (LB) of the aEEG were evaluated by semi-quantitative analysis.ResultsThe infants were divided into four groups based on head ultrasound findings: A (n = 72, normal), B [n = 16, grades 1–2 intraventricular hemorrhage (IVH)], C (n = 21, grades 3–4 IVH) and D (n = 6, periventricular leukomalacia). 18 infants (16 of group C and 2 of group D) died during hospitalization. Significantly lower values of all aEEG features were found in group C infants. The presence of pathological tracings (burst-suppression, continuous low-voltage, flat trace) or discontinuous low-voltage (DLV), the absence of Cy and LB < 3 μV in the initial aEEG displayed a sensitivity of 88.9%, 63% and 51.9% respectively, for severe brain injury. Logistic regression of aEEG features and GA to the presence or absence of severe injury revealed that only Co was significantly correlated to outcome. Using this feature 83.19% of cases were correctly classified.ConclusionPathological tracings or DLV in the initial aEEG is predictive for poor short-term outcome in premature neonates.     

Developmental change of amplitude-integrated electroencephalographic activity in preterm infants with intraventricular hemorrhage

Background

Amplitude-integrated electroencephalography (aEEG) allows continuous brain function monitoring at bedside.

Objectives

This prospective cohort study was designed to longitudinally evaluate aEEG tracings at increased postmenstrual age (PMA) in preterm infants with intraventricular hemorrhage (IVH).

Methods

Biweekly aEEG recordings were performed on preterm infants < 32 weeks gestational age from 24 to 36 weeks PMA. The tracings were evaluated according to a scoring system adapted from Burdjalov et al.

Results

We analyzed 496 aEEG recordings in 105 preterm infants. The control group consisted of 42 infants with no IVH, whereas the IVH grade I, II, III, and IV groups consisted of 38, 8, 3, and 14 infants, respectively. There were significant differences in the cycling and total maturation scores among the IVH groups at 36 weeks PMA (p = 0.010 and p = 0.006, respectively). The IVH-IV patients maintained low scores in their cycling as their PMA increased, in contrast to their continuity and amplitude scores. The risk factors affecting the aEEG maturation scores at 36 weeks PMA in the IVH-IV patients included seizure events with the administration of antiepileptic drugs and the insertion of external ventricular drains (β = − 0.679 and β = − 0.418, respectively; p = 0.003).

Conclusions

The low cycling scores persisted until 36 weeks PMA in the IVH-IV group.     

Short, middle and long-term outcome of major peri-intraventricular hemorrhages

Within 4 years 10 months (1981-1985), the Port-Royal Neonatal Intensive Care Unit admitted 2,400 neonates, one third with a birthweight below 1,501 g; 4,631 cranial ultrasound studies were performed in 1,488 of those neonates, mostly less than 1,501 g, detecting 392 consecutive peri-intraventricular hemorrhages (PIVH), of which 130 were major forms (from unilateral grade III to bilateral grade IV PIVH). Overall survival rates were 91% in grade I, 85% in grade II, 42% in grade III, 26% in grade IV; survival rate was significantly lower in bilateral than in unilateral grade II and III PIVH. In major PIVH, deaths occurred early (58% in the first week after birth). Post-hemorrhagic dilatation was constant but mostly regressive; true active hydrocephalus appeared in 1 unilateral grade III PIVH and 8 bilateral grade III PIVH, with ventriculo-peritoneal shunt in the second month of life in 5 infants (2 died), and 4 deaths (surgery not feasible). The neurological and developmental outcome of 42 of 46 survivors (4 losts to follow-up) was evaluated beyond one year of age in 12 unilateral grade III PIVH (10 normal children, 1 minor sequela, 1 moderate sequela), 16 bilateral grade III PIVH (7 normal children, 3 minor sequelae, 1 moderate sequela, 5 major sequelae), 13 unilateral grade IV PIVH (8 normal children, 1 minor sequela, 3 moderate sequelae, 1 major sequela), 1 bilateral grade IV PIVH (major sequela). A persistent major dilatation after 6-9 months of age bore an ominous prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)     

The assessment of perinatal brain damage in premature infants at risk by serial creatine kinase BB measurements]

Peri-intraventricular bleeding (PIVH) is considered the most common cause of neurologic damage or death in low birthweight infants (less than 1000 g birth weight and 31 weeks of gestation). High-resolution real-time ultrasound scan is used for early diagnosis of PIVH in neonates. Furthermore, increase of serum creatine-kinase BB (CK-BB) values has been found to be clinically useful for diagnosis and prognosis of several perinatal cerebrovascular injuries. Eighty-eight preterm infants with different grades of PIVH (I-IV) were studied by serial measurements of CK-BB levels in serum. No statistical correlation was found between enzymatic levels and severity of PIVH (p greater than 0.5).     

振幅整合脑电图对新生儿低血糖脑损伤患儿的脑功能监测意义

目的 探讨振幅整合脑电图(amplitude integrated electroencephalography,aEEG)在新生儿低血糖脑损伤急性期的改变以及其与疾病预后的相关性.方法 研究纳入2011年1月至2015年7月泉州市儿童医院新生儿重症监护室收治的47例新生儿低血糖脑损伤患儿.记录患儿的临床资料和治疗转归;采用aEEG进行脑功能监测;采用首都儿科研究所《0~6岁小儿神经心理发育检查表》进行患儿生后6月龄智能评估;分析aEEG背景活动分类,癫痫性电活动,睡眠觉醒周期,异常程度等参数与新生儿低血糖脑损伤患儿近期临床预后的相关性.结果 急性期aEEG波形:连续正常电压9例,不连续电压29例,连续低电压3例,爆发抑制6例;39例(83.0%)患儿记录到癫痫性电活动:单次惊厥、反复惊厥、惊厥持续状态分别为:11例、20例、8例;睡眠觉醒周期:无21例,不成熟17例,成熟9例.aEEG异常程度判定:正常7例,轻度异常9例,重度异常31例,其中重度异常中23例预后不良,包括死亡3例及随访至生后6月龄智能发育商≤69者20例.aEEG背景活动、睡眠觉醒周期分类以及aEEG异常程度与患儿临床近期预后通过双向有序等级相关性分析提示存在相关性(r=0.714、0.696、0.746,均P<0.001).结论 aEEG可以用于评估新生儿低血糖脑损伤患儿临床脑功能损伤严重程度及近期预后,是其脑功能监测的有用工具.     

EEG depression and germinal layer haemorrhage in the newborn

Amplitude integrated EEG (aEEG) recordings from 32 mechanically ventilated infants, gestational age 32 weeks or less, were analysed. All recordings were started within 24 h of birth and continued for at least 50 h. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultrasonography. In six infants neither GLH nor hypocalcaemia were diagnosed; aEEG in these infants rapidly became more active after birth: at 30 h of age continuous background activity was present for more than 20% of the time, and a seizure-like pattern was exceptional. In seven infants without GLH but with hypocalcaemia and other signs of metabolic derangement, continuous background activity appeared later and seizure-like activity was frequent. In the infants with GLH, depression of the background activity was apparent. This finding was particularly distinct in the presence of severe haemorrhages. Four infants developed GLH after 30 h of age. All these infants had depressed aEEG before the development of GLH, with less than 20% continuous activity at 30 h of age. In ten infants an analysis of the aEEG during the occurrence of GLH was possible. In six of these, cortical electrical activity decreased. Due to the limitation of GLH timing, it was not possible to decide whether this decrease closely preceded or followed GLH. We suggest that GLH primarily occurs in brains with a preceding metabolic and neurophysiologic abnormality, and that further functional deterioration is caused by the most severe haemorrhages.     

EEG Depression and Germinal Layer Haemorrhage in the Newborn

ABSTRACT. Amplitude integrated EEG (aEEG) recordings from 32 mechanically ventilated infants, gestational age 32 weeks or less, were analysed. All recordings were started within 24 h of birth and continued for at least 50 h. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultrasonography. In six infants neither GLH nor hypocalcaemia were diagnosed; aEEG in these infants rapidly became more active after birth: at 30 h of age continuous background activity was present for more than 20% of the time, and a seizure-like pattern was exceptional. In seven infants without GLH but with hypocalcaemia and other signs of metabolic derangement, continuous background activity appeared later and seizure-like activity was frequent. In the infants with GLH, depression of the background activity was apparent. This finding was particularly distinct in the presence of severe haemorrhages. Four infants developed GLH after 30 h of age. All these infants had depressed aEEG before the development of GLH, with less than 20% continuous activity at 30 h of age. In ten infants an analysis of the aEEG during the occurrence of GLH was possible. In six of these, cortical electrical activity decreased. Due to the limitation of GLH timing, it was not possible to decide whether this decrease closely preceded or followed GLH. We suggest that GLH primarily occurs in brains with a preceding metabolic and neurophysiologic abnormality, and that further functional deterioration is caused by the most severe haemorrhages.     

Randomized clinical trial comparing endoscopic treatment with dextranomer hyaluronic acid copolymer and Cohen's ureteral reimplantation for vesicoureteral reflux: Long-term results

PurposeTo compare efficacy of Cohen's ureteral reimplantation and endoscopic treatment with Dx/HA in patients with primary VUR grades II, III and IV.MethodsFrom April 2002 to June 2004, patients over 1 year old with VUR grade I, II, III or IV were included. Patients were randomized into two groups: endoscopic treatment (ET) or ureteral reimplantation (UR). In the ET group, an ultrasonography study was performed 24 h and 1 month after surgery, and two voiding cystourethrographies at 3 and 6 months post treatment. In the UR group, an ultrasonography study was done 7 days and 1 month after surgery and a micturial cystography 6 months post surgery. A postoperative nuclear direct cystogram was performed 5 years later in both groups.ResultsA total of 41 patients were included in this study: in ET 22 patients with 35 refluxing ureters and in UR 19 patients with 32 refluxing ureters. The VUR grades in ET were: 16 grade II, 16 grade III and 3 grade IV; and in UR: 15 grade II, 12 grade III and 5 grade IV. VUR was resolved in 91% (32/35) of ET (28% of ureters needed a second injection), and in 100% of UR group. Five years after the procedure, VUR was still resolved in 30/32 of ET and 32/32 of UR.ConclusionShort- and long-term follow up shows that multiple endoscopic treatment of VUR grades II, III and IV with Dx/HA is as effective as ureteral reimplantation.     

The influence of extrauterine life on the aEEG maturation in normal preterm infants

Objective

To study, the maturational changes of the amplitude-integrated electroencephalogram (aEEG) in preterm infants without neurological disorders and especially the influence of the duration of extrauterine life, over this process.

Methods

96 preterm infants, 25-34 weeks' gestational age (GA) at birth, clinically stable and without ultrasonographic evidence of neurological abnormalities, were studied. The aEEG recordings were obtained within 72 h of life and then weekly until discharge. Four aspects of each tracing (continuity, sleep-wake cycling, bandwidth, and lower border), were evaluated by visual analysis, applying pre-established criteria.

Results

We analysed 624 aEEG recordings at postmenstrual age (PMA) of 25-42 weeks. With advanced GA the aEEG becomes more continuous (p: 0.022), it displays definite sleep-wake cycles (p: 0.011), and its bandwidth acquires the mature pattern (p: 0.012). A positive significant interaction of GA and PMA in the evolution of aEEG was found regarding continuity (p: 0.002), sleep-wake cycling (p: 0.002), and bandwidth (p: 0.02).

Conclusion

The evolution of the aEEG tracing depends on both GA and PMA. The older the infants at birth the more mature the aEEG pattern. At the same PMA, preterm infants of lower GA display an advanced maturation of the aEEG comparing with others of higher GA.     

Need for quality control for aEEG monitoring of the preterm infant: a 2-year experience

Aim: To establish and apply a questionnaire for the evaluation of amplitude‐integrated electroencephalogram (aEEG) with respect to practicability and feasibility in the NICU, to reveal strategies for improvements in daily use and to investigate the level of staff know‐how with regard to performance and evaluation of bedside aEEG for the purpose of quality control. Methods: Amplitude‐integrated electroencephalogram was routinely applied in preterm infants below 32 weeks of gestational age for a period of 2 years. Practicability, feasibility and the level of know‐how with regard to aEEG were assessed using a multiple‐choice questionnaire. Results: Major problems in the use of aEEG in preterm infants were identified as time needed for placement and frequent readjustment of electrodes. Quality control showed the following problems: seizure activity was correctly diagnosed in 60.0%, discontinuous (DC) background in 45.5% and burst suppression (BS) in 41.8% of patients. Overall, BS and DC were the patterns most frequently interpreted incorrectly. Conclusion: Amplitude‐integrated electroencephalogram is frequently used in neonatology. In preterm infants with several challenges, repeated theoretical and practical trainings as well as quality control are needed in order for aEEG to become a routinely used monitoring instrument in daily preterm care.     

振幅整合脑电图对早产儿脑损伤的诊断价值及其影响因素

目的　探讨振幅整合脑电图(aEEG)对早产儿脑损伤(BIPI)的诊断价值及其影响因素。方法　将116例胎龄27~36+6周早产儿纳入研究, 对所有早产儿生后 6 h 内aEEG进行评分; 依据BIPI诊断结果将116例早产儿分为BIPI组(n=63)和非BIPI组(n=53), 采用logistic回归分析对导致BIPI发生的危险因素进行评估; 依据aEEG检测结果再将116例早产儿分为aEEG正常组(n=58)和aEEG异常组(n=58), 对影响早产儿aEEG结果的因素行单因素分析。结果　BIPI组中aEEG异常52 例(83%); 非BIPI组中aEEG 异常6例(11%), 两组aEEG异常率比较差异有统计学意义(P<0.05)。将早产儿依据胎龄27~33+6周和34~36+6周进行划分, BIPI组aEEG评分明显低于同胎龄非BIPI组(P<0.01)。Logistic回归分析显示：小胎龄(<32周)、低出生体重(<1 500 g)、胎盘胎膜及脐带异常和母孕期高血压是导致BIPI发生的高危因素(P<0.05)。aEEG异常组与aEEG正常组在胎龄、出生体重、胎盘胎膜及脐带异常和母孕期高血压4方面比较差异有统计学意义(P<0.05)。结论 导致BIPI发生的危险因素与影响早产儿aEEG结果的因素相一致, 提示aEEG有助于BIPI的早期诊断。     

振幅整合脑电图监测不同胎龄早产儿宫外环境下脑发育的多中心观察性研究

目的 了解宫外生活对28~36周早产儿振幅整合脑电图（aEEG）的影响。方法 以出生时无窒息抢救史早产儿为早产儿组,以胎龄37周出生后正常的新生儿为对照组;早产儿组采用振幅整合脑电图仪分别于生后3 d内,然后每周监测1次直至出院（或最长监测至纠正胎龄37周）,对照组于生后第3 d 行aEEG监测。每次连续监测4 h。分析胎龄和纠正胎龄对aEEG成熟过程影响,包括aEEG背景连续性、睡眠-觉醒周期、下边界振幅和带宽。5家参研医院均采用相同品牌和型号的aEEG,研究开始前统一进行操作技术培训,样本的临床和图像数据发送至复旦大学附属儿科医院整理。结果 2008年5月1日至2009年8 月31日5家参研医院符合本文纳入和排除标准的早产儿组135例,对照组20例。早产儿aEEG的成熟度受胎龄和纠正胎龄的影响,随胎龄和纠正胎龄增加,aEEG背景连续性和睡眠-觉醒周期出现的百分比均增加,逐步出现连续性电压（χ2=26.865,P<0.01）,≥34周出生的早产儿成熟的睡眠-觉醒周期的出现的百分比均为100％（χ2=192.4,P<0.01）;下边界振幅升高（F＝11.4,P<0.01）,带宽变窄（F＝8.731,P<0.01）。纠正胎龄和同出生胎龄的新生儿比较,连续性电压百分比、睡眠-觉醒周期的出现率均显著增加,胎龄＞34周的早产儿出生时aEEG均可见明显的睡眠-觉醒周期,而纠正胎龄32周时,睡眠-觉醒周期出现的百分比已达到100%;窄带下界也显著增高;窄带带宽变窄,至34周龄后,纠正胎龄和同出生胎龄新生儿均变化不明显。结论 早产儿aEEG的成熟度与出生胎龄和纠正胎龄相关,宫外生活加速了早产儿脑发育成熟。     

The prognostic value of amplitude integrated EEG in neonatal sepsis and/or meningitis

Aim: To investigate the longitudinal course and prognostic value of amplitude integrated EEG (aEEG) in infants with neonatal sepsis or meningitis. Methods: Amplitude integrated EEG recordings of 22 infants with sepsis/meningitis were retrospectively evaluated. Mean gestational age was 38 weeks (range: 34–42 weeks). Thirteen infants had meningitis. Survivors were seen for neurological follow‐up. Four infants died, two were severely abnormal at 24 months. Amplitude integrated EEG background pattern, sleep wake cycling (SWC) and electrographic seizure activity (EA) were appraised. Results: All infants with continuous low voltage or flat trace on aEEG (n = 4) had an adverse outcome. Low voltage aEEGs (n = 9) had a positive LR (LR+) for an adverse outcome of 5.3 (95% CI: 1.9–14.8) at 6 h and 8.3 (95% CI: 1.3–55) at 24 h after admission. EA was more frequent in infants with adverse outcome (p < 0.01) and had a LR+ for adverse outcome of 10.6 (95% CI: 1.5–76). SWC appeared more frequent in infants with good outcome (p < 0.05). Conclusion: Low voltage background pattern, SWC and EA on aEEG are helpful to predict neurological outcome in infants with neonatal sepsis or meningitis.     

Amplitude-integrated EEG differences in premature infants with and without bronchopulmonary dysplasia: a cross-sectional study

Aim: To evaluate differences in amplitude‐integrated electroencephalogram (aEEG) recordings of infants with and without bronchopulmonary dysplasia (BPD). Methods: This is a cross‐sectional study of infants ≤27 weeks at birth who did (n = 17) or did not develop BPD (n = 17). aEEG tracings were recorded at 36⁰–36⁶ weeks post‐menstrual age for 6 h using the BrainZ BRM3 monitor. A cross‐cerebral channel was evaluated using offline software Analyze (BrainZ). Results: Infants with BPD had lower gestational age and higher male predominance (25 ± 1 weeks, 70%) compared with non‐BPD infants (26 ± 1 weeks, 30%, all p ≤ 0.03), but similar birth weight (704 ± 195 vs. 796 ± 167 g, p = 0.1). During active sleep, infants with BPD had wider span voltage (p = 0.03), higher lower border voltage (p < 0.03), as well as less periods of quiet sleep per hour (p < 0.01) compared with non‐BPD infants. These differences persisted after adjustment for covariates. Conclusion: Infants with BPD have small but significant differences in their aEEG tracings compared with infants without BPD at 36 weeks. Further study of infants with BPD using aEEG appears justified to determine whether aEEG variables correlate with neurodevelopmental outcome.     

Serum prolactin in seizure disorders

This study aimed to determine the post-ictal prolactin (PL) response in different types of seizures and seizure-like events in children, and correlate with the post-ictal duration. Patients were divided into group I (generalized tonic-clonic seizures, complex partial seizures or simple partial seizures), group II (febrile convulsions) and group III (conditions mimicking seizures). Group IV consisted of 25 controls. Blood was collected within 2 hours of the seizure and PL levels assayed. PL levels were significantly high only within group I; highest and baseline levels were attained within 10 minutes and by 100 minutes respectively. The sensitivity and specificity of elevated PL for epileptic seizures were 64 percent and 98 percent respectively. It is concluded that a high prolactin level within 100 minutes of a seizure is suggestive that a generalized or complex partial seizure has occurred.