Clinical Course of Infants in Relation to EEG Monitoring

PatientDiagnosisccEEG SeizuresClinical Seizure CorrelatesSigns of Clinical SeizuresAEDs Before MonitoringTime of EEG Seizure After AEDClinical CourseNo. of AEDsInfant Outcome
AIntraventricular hemorrhage84A&D, jerking, increases in HRPB, 80 mg/kg; PHY, 40 mg/kg; CLZ, 0.5 mg/kgWithin 1 h after PB loading; additional loading dose improved controlEncephalopathic, intubated during monitoring; AED reduced frequency of electrical seizures3Died at 29 d of age
BSeizures (UC)124A&D, focal limb jerking, contralateral to EEG seizurePB, 20 mg/kg5 h; infant given loading PHY dose, with improvement in electrical seizure activityIntubated because of apnea2Mild developmental delay at 2 y
CSeizures (UC)21A&D, clonic limb jerking, mouthing, eye flickeringPB, 40 mg/kg12 h after maintenance PB doseNot intubated, sucking, oral feeding during hospital course3Normal neurologic findings at 19 mo
DExtradural hemorrhage102A&DPB, 20 mg/kgWithin 1 h after maintenance PB doseExtubated immediately before monitoring; neurologic features normalized and sucking soon after1No neurologic abnormalities noted at 1 y
EInborn error of metabolism3, then status epilepticusMultipleA&D, clonic limb jerkingPB, 40 mg/kg; PHY, 20 mg/kgIncreased frequency to status epilepticus after commencement of PHY load; required additional PB load for better controlVery difficult seizure control; intubated during course of monitoring3Developmental delay at 2 y
FSeizures (UC)51A&D, posturing, abnormal respiration pattern, increases in HRPB, 6 mg/kg; PHY, 20 mg/kgWithin 4 h after maintenance PHY doseSeizure control worsened after monitoring ceased, requiring intubation and ventilation4Died at 4 mo of age
GHIE, stage 21NoNoPB, 40 mg/kg; PHY, 15 mg/kg; CLZ, 0.5 mg/kg6 hPretreated with AEDs, monitored on third day of life3Diplegic cerebral palsy at 2 y
HHIE, stage 3No1 apnea correlated with false-positive episodeA&D requiring bag-and-mask ventilationPB, 40 mg/kgDid not require intubation and ventilation for A&D1Normal
IBronchiolitisNoNoNoNoneIntubated and ventilated for cardiorespiratory support1Alive
  • UC indicates unknown cause; HIE, hypoxic-ischemic encephalopathy; A&D, apnea and desaturation; AED, antiepileptic drug; HR, heart rate; PB, phenobarbitone; PHY, phenytoin; CLZ, clonazepam.