Positive temporal sharp waves on EEG recordings of healthy neonates: a benign pattern of dysmaturity in pre-term infants at post-conceptional term ages

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Abstract

One complete sleep cycle was selected in each of ninety-four 3 h EEG recordings on 52 healthy neonates from 29 to 43 weeks 3A (28 pre-term (PT)/24 full-term (FT)); 51 who are neurodevelopmentally normal up to at least 18 months of age. Each recording was reviewed to identify positive temporal sharp waves (PTS). This wave form was compared to another commonly occurring wave form, temporal theta of prematurity (PTΘ). 588 PTS and 626 PTΘ observations were tabulated in terms of frequency, amplitude, morphology, left: right predominance, and sleep state at 6 post-conceptional age ranges up to term. Mean PTS for FT, PT and pre-term at post-conceptional term age (PTT) infants, respectively, were 1.5 ± 0.85, 2.8 ± 2.5, 2.0 ± 1.6 per sleep cycle. PTS amplitudes (μV) were 59.7 ± 23.5, 38.2 ± 17.8, and 51.8 ± 29.3. The peak incidence of PTS occurs at older post-conceptional ages than PTΘ (r = 0.21, P = 0.0001). PTT infants had more PTS (X2 = 32.5, P = 0.001) than FT infants. Similar numbers and descriptions of PTΘ were noted between neonatal groups at post-conceptional term ages. While pathological PTS waves have been described in FT neonates and infants (Chung and Clancy: Electroenceph. clin. Neurophysiol., 1991, 79: 256–263), benign PTS waves are also present on recordings of healthy pre-term and full-term neonates. PTS are electrographically similar to PTΘ, but are more EEGs of healthy neonates will improve the assessment of encephalopathic recordings obtained for clinical reasons. Persistence of PTS at post-conceptional term ages in the pre-term group may reflect an alteration in brain maturation because of prematurity or the extrauterine experience. Increased numbers of this pattern at post-conceptional term ages reflect transient brain dysmaturity in an otherwise asymptomatic infant.

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Supported in part by Grants NS 01110 and NS 26793 to Dr. Mark S. Scher, the Scaife Family Foundation, the Twenty-Five Club of Magee-Womens Hospital, the Cradle Roll Auxillary, and the Magee-Womens Hospital Research Fund. Ms. Margie Phillips prepared the manuscript.

Presented in part at the American EEG Society Meeting, San Francisco, CA, September 1992.

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