[LS7-2C-1] Neurophysiological Aspects of Brain Injuries in Neonates
Conventional EEG (cEEG) and amplitude-integrated EEG (aEEG) have contributed to diagnosis and monitoring of brain injuries in neonates. They are useful for prognostication of asphyxiated term infants and preterm infants. Suppression of EEG activities is clear in severely affected infants. We found a worsening of EEG activities along with an appearance of neonatal seizures in term infants with latent fetal distress by using cEEG and aEEG. MRI often reveals parasagittal injuries in such infants. The timing of brain insult is different between preterm infants with periventricular leukomalacia (PVL) and those with periventricular hemorrhagic infarction (PVHI). A large majority of infants with PVL had EEG abnormalities immediately after birth, suggesting prenatal brain insult. A worsening of EEG activities often occurs after an appearance of intraventricular hemorrhage in infants with PVHI. Maturational delay in EEG activities is sometimes observed mainly in extremely preterm infants with insufficient nutrition. Head circumference may be smaller and psychomotor development may be delayed in these infants. Assessment of maturation in EEG activities can be achieved by both cEEG and aEEG, whereas cEEG will be more accurate than aEEG. Late-onset circulation failure (LOCF) is characterized by sudden occurrence of hypotension, oliguria, and hyponatremia after a stabilization of general conditions mainly in extremely preterm infants. LOCF is often followed by PVL, microcephalus, and poor neurodevelopmental outcome. aEEG revealed loss of physiological cycling before symptoms of LOCF become obvious. cEEG and aEEG add an insight into brain injuries in neonates.