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Monitoring of seizures in the newborn
  1. Divyen K Shah1,
  2. Geraldine B Boylan2,
  3. Janet M Rennie3
  1. 1Department of Neonatology, Barts and The London Children's Hospital, London, UK
  2. 2Neonatal Brain Research Group, University College Cork, Cork, Ireland
  3. 3Department of Neonatology, University College Hospitals, London, UK
  1. Correspondence to Dr Janet M Rennie, Department of Neonatology, Elizabeth Garrett Anderson Obstetric Wing, University College Hospital, 2 North 250 Euston Road, London NW1 2PQ, UK; jmr{at}janetrennie.com

Abstract

Neonatal seizures are a distinct and not uncommon sign of neurological disease in the newborn, most often occurring in association with hypoxic-ischaemic encephalopathy at term. The diagnosis and monitoring of seizures in the newborn is a considerable challenge, with many suspected clinical seizures having no electrographic correlates, while many electrographic seizures have no clinical correlate. Continuous video-EEG is the gold standard for seizure monitoring, but few centres have the resources or expertise required. Amplitude-integrated EEG can be a helpful monitoring tool in experienced hands, but has potential for error when used by inexperienced staff. Automated seizure detection algorithms show much promise and some cotside systems are already available. The efficiency and accuracy of these systems is likely to improve.

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Footnotes

  • Funding JMR and GBB are collaborators on a Translational Award from the Wellcome Trust (85249/z/08/z) investigating automated seizure detection in the newborn. Some of this work was undertaken at UCLH/UCL who received a proportion of funding from the Department of Health's NIHR Biomedical Research Centres funding scheme. The views expressed in this publication are those of the authors and not necessarily those of the Department of Health.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the hospitals concerned.

  • Provenance and peer review Commissioned; externally peer reviewed.