Published online August 10, 2009
PEDIATRICS Vol. 124 No. 3 September 2009, pp. e468-e475 (doi:10.1542/peds.2008-2967)

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ARTICLE

Chronologic Changes in Neonatal EEG Findings in Periventricular Leukomalacia

Hiroyuki Kidokoro, MD^a,b, Akihisa Okumura, MD^c, Fumio Hayakawa, MD^d, Toru Kato, MD^d, Koichi Maruyama, MD^e, Tetsuo Kubota, MD^a, Motomasa Suzuki, MD^e, Jun Natsume, MD^b, Kazuyoshi Watanabe, MD^f and Seiji Kojima, MD^b

^a Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
^b Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
^c Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan
^d Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
^e Department of Pediatric Neurology, Aichi Colony Central Hospital, Kasugai, Japan
^f Faculty of Medical Welfare, Aichi Shukutoku University, Nagakute, Japan

OBJECTIVE: This study sought to clarify chronologic changes in neonatal electroencephalographic (EEG) findings in periventricular leukomalacia (PVL).

METHODS: We obtained serial EEG findings for all premature infants who were admitted to our hospital at gestational age of 33 weeks between 1997 and 2006. EEG recordings were obtained on days 1 to 4, 5 to 14, 15 to 28, 29 to 56, and 57 to 84. Abnormal EEG findings were classified as acute-stage abnormalities (ASAs) or chronic-stage abnormalities (CSAs) and were subclassified as mild, moderate, or severe. PVL was classified as noncystic, localized cystic, or extensive cystic. The final diagnosis of PVL was made through neurologic assessment and MRI findings at 24 months.

RESULTS: Fifty-five infants were diagnosed as having PVL, including 23 with noncystic PVL, 9 with localized cystic PVL, and 23 with extensive cystic PVL. ASAs were observed most frequently on days 1 to 4 and were observed rarely thereafter in all groups. CSAs were observed most frequently on days 5 to 14, were most severe on days 5 to 14, and then resolved within 1 to 2 months in all groups. CSAs in patients with extensive cystic PVL were more severe and persisted longer, compared with other groups. ASA and CSA severity was correlated with PVL severity.

CONCLUSIONS: EEG findings in PVL differed according to the severity of PVL and the time of recording. To detect PVL, 2 EEG recordings are recommended, 1 within 48 hours after birth, to detect ASAs, and 1 in the second week of life, to detect CSAs.

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Key Words: periventricular leukomalacia • electroencephalography • preterm infants

Abbreviations: PVL—periventricular leukomalacia • EEG—electroencephalographic • PRSW—positive rolandic sharp wave • CUS—cranial ultrasonographic • ASA—acute-stage abnormality • CSA—chronic-stage abnormality

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Accepted Apr 15, 2009.

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