NEONATAL EEG: IMPORTANCE AND UTILITY IN DIFFERANTIAL DIAGNOSIS and PROGNOSIS

Objective: The objective of this study was to assess the utility of neonatal electroencephalography (EEG) in the evaluation of differential diagnosis at neonatal age and determine the relationship between seizure semiology and etiological factors. Material and Methods: Neonatal EEG’s recorded between January 2010 and January 2022 were retrospectively reviewed. Postconceptional age (Limited to neonatal age), gender, etiology, seizure semiology, neurological condition, cranial ultrasound and cranial magnetic resonance imaging (MRI) were also evaluated for seeking possible relationships between the EEG request, results, and final diagnosis. Results: Overall 543 neonatal EEG, clinical findings, and demographics were studied comprehensively. 59% of patients were male and the remaining 41% were female. As to gestational age, 52,9% patients were preterm. The most common indication for EEG requests was suspicion of seizure and to predict the degree of HIE (36.6%, 16.9%). Focal motor tonic seizures were the most common type in symptomatic etiologies (p<0,05). Phenobarbital was the common choice of antiseizure medication (%72). %48,75 of EEG records were abnormal. The backround abnormality, asymmetry and specific epileptic discharges especially lateralized hemispheric findings, burst suppression, and focality of positive and negative phase reverses pointed to abnormal cranial MRI and highly related to poor prognosis (p<0,05). Conclusions: The recent technological advances in neonatal care have changed the etiological profile of neonatal seizures. Our findings indicate that EEG plays an important role in diagnosis, early inventions, and predicting subsequent neurologic status.
Keywords: Newborn, Seizures, EEG, Differential Diagnosis, Etiology