1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-17-16-a 10.15844/pedneurbriefs-17-2-9 Neonatal Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Risk Assessment of Neonates by Neurologic Exam and Amplitude-Integrated Electroencephalography http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 02 2003 01 03 2016 17 2 16 16 Copyright: © 2003 The Author(s) 2003 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Amplitude-integrated electroencephalography coupled with an early neurologic examination enhances prediction of term infants at risk for persistent encephalopathy

The value of an early neurologic examination and amplitude-integrated electroencephalography (a-EEG) in the early identification of term infants at risk for persistent encephalopathy was evaluated in 52 infants enrolled prospectively with evidence of intrapartum distress at the University of Texas Southwestern Medical Center, Dallas, TX.

 Amplitude-Integrated Electroencephalography Short-Term Abnormal Outcome Sarnat Staging System

The value of an early neurologic examination and amplitude-integrated electroencephalography (a-EEG) in the early identification of term infants at risk for persistent encephalopathy was evaluated in 52 infants enrolled prospectively with evidence of intrapartum distress at the University of Texas Southwestern Medical Center, Dallas, TX. Infants with Apgar scores <5 at 5 min or cord arterial pH <7.00, who were admitted to intensive care, had a neurologic exam at 5 +/- 3 hours after delivery, using a modified Sarnat staging system (stages 2 and 3 are abnormal) and a blinded simultaneous a-EEG measurement using a cerebral function monitor. An abnormal short-term outcome, defined as persistent moderate to severe encephalopathy beyond 5 days, was present in 14 (28%) of 50 infants. Nine (53%) of 17 infants with stage 2 encephalopathy and both infants with stage 3 had a short-term abnormal outcome. The a-EEG was abnormal in 15 (30%) infants, 11 (73%) having an abnormal outcome. A combination of abnormal neurologic exam and abnormal a-EEG had the highest specificity (94%) and positive predictive value (85%). [1]

COMMENT. A combination of neurologic exam and a-EEG shortly after birth provides the best prediction of high-risk for abnormal outcome and persistent encephalopathy. Both evaluations can be performed by clinicians at the bedside.

Shalak LF Laptook AR Velaphi SC Perlman JM Amplitude-integrated electroencephalography coupled with an early neurologic examination enhances prediction of term infants at risk for persistent encephalopathy Pediatrics 2003 Feb 111 2 351 7 10.1542/peds.111.2.351 12563063