EEG MONITORING DURING THERAPEUTIC HYPOTHERMIA AND ITS CORRELATION WITH NEURONAL BRAIN INJURY ON MRI IN NEWBORNS WITH HYPOXIC ISCHEMIC ENCEPHALOPATHY

Dr. Sudhir Mehta*

ABSTRACT

Background: Therapeutic hypothermia (TH) is becoming a neuroprotective strategy for neonatal hypoxic-ischemic encephalopathy (HIE).The prognostic value of the EEG for neuronal outcome during TH is still uncertain. Aim: To determine EEG background, incidence of seizures during Therapeutic hypothermia, and to identify different patterns of EEG predictive for MRI brain injury. Patients and Methods: This study was conducted on 70 newborns with HIE who underwent TH. Continuous video-EEG monitoring was performed during hypothermia and rewarming. EEG background and seizure patterns were reported in a standardized fashion. Newborns had undergone MRI brain after rewarming. Sensitivity and specificity of EEG background for moderate to severe MRI brain injury was assessed at 6-hour intervals during TH and rewarming Findings: At all-time points, a normal EEG was associated with no or mild MRI brain injury and predictive of a favorable MRI outcome (100% specific) than at later time points (90% specific). Burst suppression and low voltage patterns held the greatest prognostic value only after 24-48 hours of monitoring, with a specificity of 85%. Electrographic seizures occurred in 50% (35/70), and 10% (7/70) developed status epileptics. Conclusions: Continuous video-EEG monitoring in newborns with HIE undergoing TH has a prognostic value about early MRI brain-findings.

Keywords: Therapeutic hypothermia, EEG, MRI.