Amplitude-integrated EEG (EEG)

سال انتشار: 1398
نوع سند: مقاله کنفرانسی
زبان: انگلیسی
مشاهده: 343

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شناسه ملی سند علمی:

INHCMED06_025

تاریخ نمایه سازی: 30 آذر 1398

چکیده مقاله:

In 1969, Prior and Maynard first described the method in adults. In the 1970s and 1980s, the method was increasingly used with children. First publications detailing its use in neonates date back to the late 1980. aEEG method experienced its first significant improvement in the 1990s when digital technology increased greatly. Now the original raw EEG was displayed and recorded together with the aEEG. Its clinical use was mainly for: 1) Detection of cerebral seizure activity 2) Surveillance of antiepileptic drug treatment 3) prediction of cerebral outcome after birth asphyxia 4) Identifying neonatal asphyxia suitable for hypothermia 5) Correlation between early aEEG recordings and neurodevelopmental outcomes in preterm infants. aEEG has been proven that is beneficial method because of: 1) a safe method even in extremely preterm infants 2) generally well-accepted by NICU staff 3) limited number of electrode 4) relatively short training required for interpretation 5) immediate interpretation 6) available at the bedside 7) Lower cost 8) continuous and long term recording aEEG background pattern changes according to the infant s gestational age. With increasing gestational age. aEEG and background patterns become more continuous, and the duration of continuous activity increases. In term infants and late preterm infants the background pattern is mainly continuous. During quiet sleep the background pattern becomes more discontinuous. In very preterm infants, the dominating background pattern is discontinuous episodes of high activity (highamplitude bursts) alternate with episodes of low-amplitude activity. This physiological pattern must be distinguished from a burst suppression pattern, which is pathological Identifying and evaluating the pattern step-by-step:1. Impedances 2. Background activity 3. Sleep-wake cycles 4. Seizures (individual or repeated seizures, status epilepticus) 5. Event markings 6. Symmetry 7. Indicationspecific view , 8. Assessment Hellstrom Westas: Background patterns: Continuous normal voltage (physiological) (Min > 5, Max > 10) Discontinuous normal voltage (physiological in preterm infants) (Min <5, Max > 10) Burst suppression pattern (pathological) (Min < 5 with no variability, Max > 10 with hi-voltage bursts) Continuous low voltage (pathological) ( Min <5, Max < 10) Flat trace (pathological) (Min and Max < 5) Sleep-wake cycling: none, imminent, mature (physiological/ pathological, depending on the infant s age) Seizure activity: none, single seizures, repetitive seizures, and status epilepticus Changes in a EEG tracing are caused by numerous extracortical factors:Changes in cerebral blood flow Medication: opiates, sedatives, and caffeine Acidosis: changes in carbon dioxide tension Clinical conditions: hypogylcemia, sepsis, meningitis Artifacts may pose a problem for interpretation: Absolute values of the amplitude change as a consequence of scalp edema Interelectrode distance Interferences caused by ECG High-frequency oscillation ventilation, muscle activity, infant movement may result in a lower border increase

نویسندگان

Mohammad Vafaee Shahi

MD Assistant professor of pediatric neurology Iran University of Medical sciences