Abstracts

Rationale: Therapeutic hypothermia (TH) is used widely in neonatal hypoxic-ischemic encephalopathy (HIE). There has been only one study of TH in neonatal HIE that demonstrated the value of continuous video-EEG in identifying subclinical seizures, and in providing prognostic information by correlating the EEG background with brain MRI as an early outcome measure. We reviewed our experience with 20 infants with HIE who underwent TH and continuous video-EEG and included clinical outcome to add to the body of knowledge and to further assess the longer term prognostic value of the EEG background.Methods: 20 infants with HIE who had TH and continuous video-EEG were studied retrospectively. All infants were treated according to a standard clinical protocol for TH. Video-EEG monitoring continued for a minimum of 72 hours during whole body cooling and during rewarming. MRI was obtained on day of life 3 or later. The EEG was analyzed for background and for the presence of seizures, which were electrographic or clinical. Clinical outcome was correlated when available. Results: see tableConclusions: Video-EEG monitoring during TH in neonates with HIE is useful in providing prognostic information for both MRI as an early outcome measure and for clinical outcome. Subclinical electrographic seizures are detected reliably, and suspected clinical seizures can be reliably identified as well, avoiding unnecessary treatment of non-epileptic events. The prognostic value of the EEG background can be useful clinically earlier than the MRI, and may be more sensitive than MRI in predicting long-term neurological outcome.