Mathieson, SR,Livingstone, V,Low, E,Pressler, R,Rennie, JM,Boylan, GB

2016

October

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology

Phenobarbital reduces EEG amplitude and propagation of neonatal seizures but does not alter performance of automated seizure detection

Validated

()

Electroclinical uncoupling Neonatal seizures Automated seizure detection HYPOXIC-ISCHEMIC ENCEPHALOPATHY DETECTION ALGORITHM ELECTROENCEPHALOGRAPHY MECHANISM SYSTEM

127

3343

3350

Objective: Phenobarbital increases electroclinical uncoupling and our preliminary observations suggest it may also affect electrographic seizure morphology. This may alter the performance of a novel seizure detection algorithm (SDA) developed by our group.Objective: The objectives of this study were to compare the morphology of seizures before and after phenobarbital administration in neonates and to determine the effect of any changes on automated seizure detection rates.Methods: The EEGs of 18 term neonates with seizures both pre- and post-phenobarbital (524 seizures) administration were studied. Ten features of seizures were manually quantified and summary measures for each neonate were statistically compared between pre- and post-phenobarbital seizures. SDA seizure detection rates were also compared.Results: Post-phenobarbital seizures showed significantly lower amplitude (p < 0.001) and involved fewer EEG channels at the peak of seizure (p < 0.05). No other features or SDA detection rates showed a statistical difference.Conclusion: These findings show that phenobarbital reduces both the amplitude and propagation of seizures which may help to explain electroclinical uncoupling of seizures. The seizure detection rate of the algorithm was unaffected by these changes.Significance: The results suggest that users should not need to adjust the SDA sensitivity threshold after phenobarbital administration. (C) 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd.

10.1016/j.clinph.2016.07.007