TY - JOUR T1 - Characterisation of neonatal seizures and their treatment using continuous EEG monitoring: a multicentre experience JF - Archives of Disease in Childhood - Fetal and Neonatal Edition JO - Arch Dis Child Fetal Neonatal Ed SP - F493 LP - F501 DO - 10.1136/archdischild-2018-315624 VL - 104 IS - 5 AU - Janet M Rennie AU - Linda S de Vries AU - Mats Blennow AU - Adrienne Foran AU - Divyen K Shah AU - Vicki Livingstone AU - Alexander C van Huffelen AU - Sean R Mathieson AU - Elena Pavlidis AU - Lauren C Weeke AU - Mona C Toet AU - Mikael Finder AU - Raga Mallika Pinnamaneni AU - Deirdre M Murray AU - Anthony C Ryan AU - William P Marnane AU - Geraldine B Boylan Y1 - 2019/09/01 UR - http://fn.bmj.com/content/104/5/F493.abstract N2 - Objective The aim of this multicentre study was to describe detailed characteristics of electrographic seizures in a cohort of neonates monitored with multichannel continuous electroencephalography (cEEG) in 6 European centres.Methods Neonates of at least 36 weeks of gestation who required cEEG monitoring for clinical concerns were eligible, and were enrolled prospectively over 2 years from June 2013. Additional retrospective data were available from two centres for January 2011 to February 2014. Clinical data and EEGs were reviewed by expert neurophysiologists through a central server.Results Of 214 neonates who had recordings suitable for analysis, EEG seizures were confirmed in 75 (35%). The most common cause was hypoxic-ischaemic encephalopathy (44/75, 59%), followed by metabolic/genetic disorders (16/75, 21%) and stroke (10/75, 13%). The median number of seizures was 24 (IQR 9–51), and the median maximum hourly seizure burden in minutes per hour (MSB) was 21 min (IQR 11–32), with 21 (28%) having status epilepticus defined as MSB>30 min/hour. MSB developed later in neonates with a metabolic/genetic disorder. Over half (112/214, 52%) of the neonates were given at least one antiepileptic drug (AED) and both overtreatment and undertreatment was evident. When EEG monitoring was ongoing, 27 neonates (19%) with no electrographic seizures received AEDs. Fourteen neonates (19%) who did have electrographic seizures during cEEG monitoring did not receive an AED.Conclusions Our results show that even with access to cEEG monitoring, neonatal seizures are frequent, difficult to recognise and difficult to treat.Oberservation study number NCT02160171 ER -