IRIS publication 43335607
Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures
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TY - JOUR - Murray, DM,Boylan, GB,Ali, I,Ryan, CA,Murphy, BP,Connolly, S - 2008 - May - Archives of Disease In Childhood - Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures - Validated - () - EEG CLASSIFICATION PHENYTOIN NEWBORNS INFANTS - 93 - 187 - 191 - Background: Neonatal seizures are often subclinical, making accurate diagnosis difficult.Objective: To describe the clinical manifestations of electrographic seizures recorded on continuous video-EEG, and to compare this description with the recognition of clinical seizures by experienced neonatal staff.Methods: Term infants, at risk of seizures, were monitored by continuous 12-channel video-EEG from <6 hours of birth for up to 72 hours. All clinical seizures were recorded by experienced neonatal staff on individual seizure charts. Video-EEG recordings were subsequently analysed. The number, duration and clinical expression of electrographic seizures were calculated (in seconds), and compared with the seizures clinically suspected by the neonatal staff.Results: Of 51 infants enrolled, nine had electrographic seizures. A further three had clinically suspected seizures, without associated electrographic abnormality. Of the total 526 electrographic seizures, 179 (34%) had clinical manifestations evident on the simultaneous video recording. The clinical seizure activity corresponded to 18.8% of the total electrographic seizure burden. Overdiagnosis also occurred frequently. Of the 177 clinically suspected seizure episodes documented by staff, 48 (27%) had corresponding electrographic evidence of seizure activity Thus, only 9% (48/526) of electrographic seizures were accompanied by clinical manifestations, which were identified and documented by neonatal staff.Conclusion: Only one-third of neonatal EEG seizures displays clinical signs on simultaneous video recordings. Moreover, two-thirds of these clinical manifestations are unrecognised, or misinterpreted by experienced neonatal staff. In the recognition and management of neonatal seizures clinical diagnosis alone is not enough. - DOI 10.1136/adc.2005.086314 DA - 2008/05 ER -
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@article{V43335607, = {Murray, DM and Boylan, GB and Ali, I and Ryan, CA and Murphy, BP and Connolly, S }, = {2008}, = {May}, = {Archives of Disease In Childhood}, = {Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures}, = {Validated}, = {()}, = {EEG CLASSIFICATION PHENYTOIN NEWBORNS INFANTS}, = {93}, pages = {187--191}, = {{Background: Neonatal seizures are often subclinical, making accurate diagnosis difficult.Objective: To describe the clinical manifestations of electrographic seizures recorded on continuous video-EEG, and to compare this description with the recognition of clinical seizures by experienced neonatal staff.Methods: Term infants, at risk of seizures, were monitored by continuous 12-channel video-EEG from <6 hours of birth for up to 72 hours. All clinical seizures were recorded by experienced neonatal staff on individual seizure charts. Video-EEG recordings were subsequently analysed. The number, duration and clinical expression of electrographic seizures were calculated (in seconds), and compared with the seizures clinically suspected by the neonatal staff.Results: Of 51 infants enrolled, nine had electrographic seizures. A further three had clinically suspected seizures, without associated electrographic abnormality. Of the total 526 electrographic seizures, 179 (34%) had clinical manifestations evident on the simultaneous video recording. The clinical seizure activity corresponded to 18.8% of the total electrographic seizure burden. Overdiagnosis also occurred frequently. Of the 177 clinically suspected seizure episodes documented by staff, 48 (27%) had corresponding electrographic evidence of seizure activity Thus, only 9% (48/526) of electrographic seizures were accompanied by clinical manifestations, which were identified and documented by neonatal staff.Conclusion: Only one-third of neonatal EEG seizures displays clinical signs on simultaneous video recordings. Moreover, two-thirds of these clinical manifestations are unrecognised, or misinterpreted by experienced neonatal staff. In the recognition and management of neonatal seizures clinical diagnosis alone is not enough.}}, = {DOI 10.1136/adc.2005.086314}, source = {IRIS} }
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AUTHORS | Murray, DM,Boylan, GB,Ali, I,Ryan, CA,Murphy, BP,Connolly, S | ||
YEAR | 2008 | ||
MONTH | May | ||
JOURNAL_CODE | Archives of Disease In Childhood | ||
TITLE | Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures | ||
STATUS | Validated | ||
TIMES_CITED | () | ||
SEARCH_KEYWORD | EEG CLASSIFICATION PHENYTOIN NEWBORNS INFANTS | ||
VOLUME | 93 | ||
ISSUE | |||
START_PAGE | 187 | ||
END_PAGE | 191 | ||
ABSTRACT | Background: Neonatal seizures are often subclinical, making accurate diagnosis difficult.Objective: To describe the clinical manifestations of electrographic seizures recorded on continuous video-EEG, and to compare this description with the recognition of clinical seizures by experienced neonatal staff.Methods: Term infants, at risk of seizures, were monitored by continuous 12-channel video-EEG from <6 hours of birth for up to 72 hours. All clinical seizures were recorded by experienced neonatal staff on individual seizure charts. Video-EEG recordings were subsequently analysed. The number, duration and clinical expression of electrographic seizures were calculated (in seconds), and compared with the seizures clinically suspected by the neonatal staff.Results: Of 51 infants enrolled, nine had electrographic seizures. A further three had clinically suspected seizures, without associated electrographic abnormality. Of the total 526 electrographic seizures, 179 (34%) had clinical manifestations evident on the simultaneous video recording. The clinical seizure activity corresponded to 18.8% of the total electrographic seizure burden. Overdiagnosis also occurred frequently. Of the 177 clinically suspected seizure episodes documented by staff, 48 (27%) had corresponding electrographic evidence of seizure activity Thus, only 9% (48/526) of electrographic seizures were accompanied by clinical manifestations, which were identified and documented by neonatal staff.Conclusion: Only one-third of neonatal EEG seizures displays clinical signs on simultaneous video recordings. Moreover, two-thirds of these clinical manifestations are unrecognised, or misinterpreted by experienced neonatal staff. In the recognition and management of neonatal seizures clinical diagnosis alone is not enough. | ||
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DOI_LINK | DOI 10.1136/adc.2005.086314 | ||
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