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Title: Small Bedside Monitors Detect Seizures in At-Risk Newborns
URL: http://www.pslgroup.com/dg/224D4E.htm
Doctor's Guide
July 2, 2008

ST. LOUIS, Mo -- July 2, 2008 -- Compact, bedside, amplitude-integrated electroencephalographic (aEEG) monitors are able to detect most seizures in at-risk infants, which could assist clinicians in monitoring for electrical seizures until confirmation with a conventional electroencephalography (EEG), according to a study published in the June issue of Pediatrics.

Researchers at Washington University School of Medicine, St. Louis, Missouri, conducted a side-by-side comparison of aEEG with conventional EEG. They used both technologies simultaneously for an average of 18 hours per patient to monitor the brain activity of 21 newborns who had experienced seizures.

They also compared 3 different aEEG setups: (1) produced a tracing from only 1 channel, (2) produced tracings from 2 channels, and (3) produced tracings from 2 channels but also included raw, uncompressed brain-wave tracings.

"We found that we could pick up seizure activity in most of the patients using aEEG monitors that included the raw signals," said lead author Divyen Shah, MD. "In most medical centres worldwide, conventional EEG isn't available because it's expensive and resource intensive. We've shown that when staff members have training in interpreting aEEG, it can be effective for monitoring electrical seizure activity in newborns."

With conventional EEG, the researchers detected multiple seizures in 7 of the infants, and with aEEG plus the raw signals, they detected most of those seizures (76%) in 6 of those babies. The seventh baby had 1 brief seizure, which was missed by aEEG monitoring.

Although aEEG has the advantage of lower cost and ease of use, the study also showed that its compression of raw brain wave data can make certain types of seizures harder to detect. However, the research also demonstrated that this disadvantage can be largely overcome with the use of aEEG monitors that also output an uncompressed and unfiltered tracing. That raw tracing provides a backup reading to check against any ambiguous reading from the compressed data.

The researchers found that aEEG plus the raw signals yielded better results than unsupplemented aEEG, which missed all of 5 seizures experienced by 1 of the newborns. The research team emphasises that although aEEG monitors can complement conventional EEG, they cannot completely replace it for electrical seizure detection.

SOURCE: Washington University

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