Abstracts

Rationale: To determine onset of EEG confirmed seizures and correlate this with observation of clinical seizures. Methods: 56 newborns with NE received whole-body hypothermia (esophageal temperature of 33.5°C) for 72 hours [Shankaran et al 2005] with continuous video-EEG monitoring throughout hypothermia and rewarming. Analysis was performed on 53 patients whose EEGs were available for review. The EEG was reviewed by a pediatric epileptologist for seizures. Medical records were reviewed for observation of clinical seizures. Results: Cooling was started at mean age 4.4 ± 1.1 hr. EEG recording began at median 10.0 hrs of life (range 3.7-31 hrs). 33 patients had at least one clinical seizure. Of these patients, 11 had EEG confirmed seizures. 20 patients had no clinically reported seizures. Of these patients, 4 had EEG confirmed seizures. Only one patient had any clinical behavior suggestive of seizures when the seizures began on EEG. Seizures were detected on EEG within 37 hrs of life. 8/15 had seizures within 24 hours of life. Conclusions: Clinical report of seizures both overestimates and underestimates seizures confirmed on video EEG. Seizures in our patient population occurred within 37 hours of life. This suggests that continuous video EEG recordings within the first 48 hours of life are necessary to accurately determine seizure burden.