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Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring.

Publication ,  Journal Article
Wusthoff, CJ; Sundaram, V; Abend, NS; Massey, SL; Lemmon, ME; Thomas, C; McCulloch, CE; Chang, T; Soul, JS; Chu, CJ; Rogers, EE; Bonifacio, SL ...
Published in: Neurology
August 10, 2021

OBJECTIVE: To determine whether screening continuous EEG monitoring (cEEG) is associated with greater odds of treatment success for neonatal seizures. METHODS: We included term neonates with acute symptomatic seizures enrolled in the Neonatal Seizure Registry (NSR), a prospective, multicenter cohort of neonates with seizures. We compared 2 cEEG approaches: (1) screening cEEG, initiated for indications of encephalopathy or paralysis without suspected clinical seizures; and (2) confirmatory cEEG, initiated for the indication of clinical events suspicious for seizures, either alone or in addition to other indications. The primary outcome was successful response to initial seizure treatment, defined as seizures resolved without recurrence within 30 minutes after initial loading dose of antiseizure medicine. Multivariable logistic regression analyses assessed the association between cEEG approach and successful seizure treatment. RESULTS: Among 514 neonates included, 161 (31%) had screening cEEG and 353 (69%) had confirmatory cEEG. Neonates with screening cEEG had a higher proportion of successful initial seizure treatment than neonates with confirmatory cEEG (39% vs 18%; p < 0.0001). After adjusting for covariates, there remained a greater odds ratio (OR) for successful initial seizure treatment in the screening vs confirmatory cEEG groups (adjusted OR 2.44, 95% confidence interval 1.45-4.11, p = 0.0008). CONCLUSIONS: These findings provide evidence from a large, contemporary cohort of neonates that a screening cEEG approach may improve odds of successful treatment of acute seizures. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that for neonates a screening cEEG approach, compared to a confirmatory EEG approach, increases the probability of successful treatment of acute seizures.

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Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

August 10, 2021

Volume

97

Issue

6

Start / End Page

e587 / e596

Location

United States

Related Subject Headings

  • Seizures
  • Registries
  • Outcome Assessment, Health Care
  • Neurophysiological Monitoring
  • Neurology & Neurosurgery
  • Male
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Female
 

Citation

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Wusthoff, C. J., Sundaram, V., Abend, N. S., Massey, S. L., Lemmon, M. E., Thomas, C., … Neonatal Seizure Registry Group, . (2021). Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring. Neurology, 97(6), e587–e596. https://doi.org/10.1212/WNL.0000000000012293
Wusthoff, Courtney J., Vandana Sundaram, Nicholas S. Abend, Shavonne L. Massey, Monica E. Lemmon, Cameron Thomas, Charles E. McCulloch, et al. “Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring.Neurology 97, no. 6 (August 10, 2021): e587–96. https://doi.org/10.1212/WNL.0000000000012293.
Wusthoff CJ, Sundaram V, Abend NS, Massey SL, Lemmon ME, Thomas C, et al. Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring. Neurology. 2021 Aug 10;97(6):e587–96.
Wusthoff, Courtney J., et al. “Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring.Neurology, vol. 97, no. 6, Aug. 2021, pp. e587–96. Pubmed, doi:10.1212/WNL.0000000000012293.
Wusthoff CJ, Sundaram V, Abend NS, Massey SL, Lemmon ME, Thomas C, McCulloch CE, Chang T, Soul JS, Chu CJ, Rogers EE, Bonifacio SL, Cilio MR, Glass HC, Shellhaas RA, Neonatal Seizure Registry Group. Seizure Control in Neonates Undergoing Screening vs Confirmatory EEG Monitoring. Neurology. 2021 Aug 10;97(6):e587–e596.

Published In

Neurology

DOI

EISSN

1526-632X

Publication Date

August 10, 2021

Volume

97

Issue

6

Start / End Page

e587 / e596

Location

United States

Related Subject Headings

  • Seizures
  • Registries
  • Outcome Assessment, Health Care
  • Neurophysiological Monitoring
  • Neurology & Neurosurgery
  • Male
  • Infant, Newborn, Diseases
  • Infant, Newborn
  • Humans
  • Female