The electroencephalogram of the full-term newborn: review of normal features and hypoxic-ischemic encephalopathy patterns

Abstract

Objective: The objective of this study is to specify, by reference to the normal newborn, the current contribution of the electroencephalogram (EEG) to the diagnosis and prognosis of hypoxic-ischemic encephalopathy (HIE) in the full-term newborn. Both digitized traditional EEG and cerebral function monitoring will be considered.

Discussion: A good knowledge of the EEG features of the sleep-wake cycle (SWC) is a prerequisite. We first describe the main features of normal and pathological EEGs. Very early recordings (before 6hours of life) are needed to indicate any required neuroprotective (hypothermia) and other (sedation, anticonvulsivants) treatments.

Conclusions: Between the normal or near-normal tracings, which are associated with a good prognosis, and the very pathological ones (inactive, paroxysmal), which are associated with a poor vital or neurological prognosis, the interpretation of "intermediate" tracings--mainly represented by other types of discontinuous tracings--must take into account characteristics such as bursts and discontinuities, postnatal age, evolution of successive tracings, and treatments.

Keywords: AEEG; Cerebral function monitoring; EEG; EEG patterns; Encéphalopathie hypoxo-ischémique; Epilepsy; Full-term newborn; Hypoxic-ischemic encephalopathy; Monitoring; Normes; Nouveau-né à terme; Prognosis; Pronostic; Épilepsie.