Article
Pediatrics
Poorva Deshpande, Amish Jain, Patrick J. McNamara
Summary: Phenobarbitone significantly suppresses cerebral electrical activity in infants with HIE undergoing TH, leading to worsening of background patterns on aEEG. Development of severe aEEG background patterns after phenobarbitone administration may be associated with MRI brain death or moderate-to-severe injury.
Article
Neurosciences
Xiangjun Cui, Bin Zhou, Jiebin Wu, Dong Yang, Xiao Liu, Yun Wang
Summary: The study revealed that brain injury induced by neonatal hyperbilirubinemia significantly affected the amplitude-integrated electroencephalography results, as well as increased levels of neuron-specific enolase and S100B. The combination of aEEG, NSE, and S100B showed good diagnostic value in diagnosing brain injury and predicting prognosis.
Article
Neurosciences
Bahar Saadatmehr, Mohammadreza Edalati, Laura Routier, Mahdi Mahmoudzadeh, Javad Safaie, Guy Kongolo, Ghida Ghostine, Fabrice Wallois, Sahar Moghimi
Summary: Temporal theta activity in coalescence with slow-wave (TTA-SW) is an early neurodevelopmental biomarker that can be measured through EEG. This study found that during neurodevelopment, there is a gradual enhancement of SW theta phase-amplitude coupling (PAC), primarily concentrated near the trough of the SW. The steepness of the SW's slope is related to the intensity of PAC, indicating a close relationship between PAC and neurodevelopment.
Article
Pediatrics
Poorva Deshpande, Julia Dirks, Amish Jain, Patrick J. McNamara, Cecil Hahn, Prakesh S. Shah, Anne-Marie Guerguerian
Summary: The aim of this study was to investigate the patterns of aEEG cyclicity, background pattern, voltage margins, and maturation scores in ELGANs during the first 72 hours. The results showed that clinically stable ELGANs without neurological injury demonstrated increased cyclicity compared to those with a complicated course, and maturation score, high and low base voltage increased over time.
Review
Pediatrics
Poorva Deshpande, Patrick J. McNamara, Cecil Hahn, Prakesh S. Shah, Anne-Marie Guerguerian
Summary: This article reviews the literature on normal and abnormal aEEG patterns in preterm infants and proposes a stepwise clinical algorithm for aEEG assessment at the bedside.
EUROPEAN JOURNAL OF PEDIATRICS
(2022)
Review
Clinical Neurology
Obertino Dilena, Federico Raviglione, Gaetano Cantalupo, Duccio M. Cordelli, Paola De Liso, Matteo Di Capua, Raffaele Falsaperla, Fabrizio Ferrari, Monica Fumagalli, Silvia Lori, Agnese Suppiej, Laura Tadini, Bernardo Dalla Bernardina, Massimo Mastrangelo, Francesco Pisani
Summary: This work aims to establish inclusive guidelines on electroencephalography (EEG) for all neonatal intensive care units (NICUs), while proposing shared recommendations for video EEG and amplitude-integrated EEG to promote collaboration between neonatal units of different complexity levels and provide suggestions for organizational restructuring and tele-neurophysiology implementation.
CLINICAL NEUROPHYSIOLOGY
(2021)
Article
Pediatrics
Gabriel F. T. Variane, Rafaela F. R. Pietrobom, Caroline Y. Noh, Krisa P. Van Meurs, Valerie Y. Chock
Summary: Continuous neuromonitoring in Neonatal Intensive Care Unit (NICU) allows for bedside assessment of oxygenation, perfusion, cerebral function and seizures. Near-infrared spectroscopy (NIRS) provides organ-specific assessment of perfusion, while amplitude-integrated electroencephalography (aEEG) evaluates cerebral function and identifies seizures. Multi-modality monitoring combines brain and vital sign monitoring, facilitating understanding of physiology.
FRONTIERS IN PEDIATRICS
(2023)
Article
Engineering, Biomedical
Chen Chen, Yan Xu, Zeyu Wang, Chenglu Sun, Xian Zhao, Jiahao Fan, Hendrik Niemarkt, Peter Andriessen, Laishuan Wang, Wei Chen
Summary: This paper investigates the digital transformation procedure of deriving amplitude-integrated (a)EEG from raw EEG and evaluates the impact of different filters and envelope detection methods. The results demonstrate that the proposed approach achieved excellent performance in a clinical dataset, promoting the standardization of aEEG transformation procedure and exploration of automatic interpretation algorithms.
BIOMEDICAL SIGNAL PROCESSING AND CONTROL
(2021)
Review
Pediatrics
Mohamed El-Dib, Nicholas S. J. Abend, Topun Austin, Geraldine Boylan, Valerie Chock, M. Roberta Cilio, Gorm Greisen, Lena Hellstroem-Westas, Petra Lemmers, Adelina Pellicer, Ronit Pressler, Arnold Sansevere, Tammy Tsuchida, Sampsa Vanhatalo, Courtney J. Wusthoff
Summary: The development of neonatal neurocritical care in the past decade has shown significant progress in neuromonitoring and neuroprotection. Commonly used brain monitoring tools in the neonatal intensive care unit (NICU) include amplitude integrated EEG (aEEG), full multichannel continuous EEG (cEEG), and near-infrared spectroscopy (NIRS). However, there is no consensus on the consistent and efficient use of these modalities in common NICU scenarios. This review summarizes current evidence for the best utilization of neuromonitoring modalities in neonates with encephalopathy or possible seizures.
PEDIATRIC RESEARCH
(2023)
Article
Multidisciplinary Sciences
Tim Hermans, Katherine Carkeek, Anneleen Dereymaeker, Katrien Jansen, Gunnar Naulaers, Sabine Van Huffel, Maarten De Vos
Summary: In neonates with hypoxic ischemic encephalopathy, the use of wavelet coherence between EEG power and rSO2 is a promising method for assessing neurovascular coupling. However, fluctuations in SpO2 limit the reliability of previous methods. To address this issue, partial wavelet coherence is proposed to eliminate the influence of SpO2. Furthermore, the study investigates the additional value of novel NVC biomarkers compared to traditional EEG and NIRS biomarkers for identifying brain injury.
SCIENTIFIC REPORTS
(2023)
Article
Pediatrics
Christina Schreiner, Maria Sappler, Michaela Hoeck, Marlene Hammerl, Vera Neubauer, Ursula Kiechl-Kohlendorfer, Elke Griesmaier
Summary: The study found no impairment on amplitude-integrated electroencephalography signals in preterm infants receiving low-dose prophylactic paracetamol compared to controls. The paracetamol group showed a higher number of sleep-wake cycles per hour compared to the control group.
FRONTIERS IN PEDIATRICS
(2022)
Review
Pediatrics
Valerie Y. Chock, Anoop Rao, Krisa P. Van Meurs
Summary: Neonates with hypoxic ischemic encephalopathy (HIE) are at significant risk for adverse outcomes. Neuromonitoring provides critical diagnostic and prognostic information. Various modalities such as cEEG, aEEG, NIRS, and heart rate variability can be used for continuous monitoring, while cranial ultrasound and evoked potentials are used for serial bedside monitoring. Integrated use of these techniques, along with therapeutic hypothermia, can predict imaging outcomes and long-term neurodevelopment.
FRONTIERS IN PEDIATRICS
(2023)
Article
Obstetrics & Gynecology
Christina Schreiner, Marlene Hammerl, Vera Neubauer, Ursula Kiechl-Kohlendorfer, Elke Griesmaier
Summary: The study showed that preterm infants with cerebral hemorrhage have alterations in aEEG signals, with lower Burdjalo scores indicating the presence of cerebral hemorrhage. A Burdjalo total score of seven or more was predictive for no development of cerebral hemorrhage, with the highest area under the curve occurring on postnatal day three. The use of aEEG in early life could help monitor preterm infants at risk for cerebral hemorrhage and reduce the number of ultrasound examinations.
EARLY HUMAN DEVELOPMENT
(2021)
Review
Pediatrics
Nathan J. Stevenson, Melissa M. Lai, Hava E. Starkman, Paul B. Colditz, Julie A. Wixey
Summary: This review explores the potential of electroencephalography (EEG) as a tool for assessing brain development in fetuses with growth restriction (FGR) or born small for gestational age (SGA). Findings suggest that FGR/SGA is associated with measurable changes in EEG immediately after birth and into childhood. Early manifestations in EEG include changes in spectral power, symmetry/synchrony, sleep-wake cycling, and continuity of EEG amplitude, while later manifestations include changes in spectral power, sleep architecture, and EEG amplitude. FGR/SGA infants also show poorer neurodevelopmental outcomes compared to those appropriate for gestational age (AGA). EEG has the potential to identify FGR/SGA infants and assess the functional correlates of neurological damage.
PEDIATRIC RESEARCH
(2022)
Article
Pediatrics
Cynthia M. Ortinau, Christopher D. Smyser, Lindsay Arthur, Erin E. Gordon, Haleh C. Heydarian, Joshua Wolovits, Jonathan Nedrelow, Bradley S. Marino, Victor Y. Levy
Summary: Neurodevelopmental impairment is a common and important long-term morbidity among infants with congenital heart disease. More than half of those with complex CHD will demonstrate some form of neurodevelopmental, neurocognitive, and/or psychosocial dysfunction. Preventing brain injury and treating long-term neurologic sequelae is crucial for improving neurodevelopmental and psychosocial outcomes. Cardiac neurodevelopmental care is now at the forefront of clinical and research efforts.
Article
Obstetrics & Gynecology
Eniko Szakmar, Jennifer Smith, Edward Yang, Joseph J. Volpe, Terrie Inder, Mohamed El-Dib
Summary: This study found that monitoring cerebral oxygen saturation using near infrared spectroscopy during therapeutic hypothermia and rewarming can help identify the risk of brain injury, with particular effectiveness in distinguishing gray matter injury.
JOURNAL OF PERINATOLOGY
(2021)
Article
Obstetrics & Gynecology
Katherine M. Ottolini, Sudeepta K. Basu, Nicole Herrera, Vedavalli Govindan, Suleiman Mashat, Gilbert Vezina, Michelande Ridore, James Bost, Taeun Chang, An N. Massaro
Summary: The study investigated the association between fluid balance during therapeutic hypothermia and severity of brain injury on MRI in neonates with HIE. Positive fluid balance during TH was independently associated with death or moderate-to-severe brain injury on MRI.
JOURNAL OF PERINATOLOGY
(2021)
Article
Clinical Neurology
E. Szakmar, H. Meunier, M. El-Dib, E. Yang, T. E. Inder
Summary: A novel MR imaging scoring system was used to evaluate hypoxic-ischemic brain injury in infants, showing excellent interobserver reliability and establishing cutoff values for injury severity. Adjusting the scoring system may improve interrater agreement, and the presented cutoff values may be useful in future studies determining the severity of brain injury.
AMERICAN JOURNAL OF NEURORADIOLOGY
(2021)
Article
Obstetrics & Gynecology
Brian H. Walsh, Chelsea Munster, Hoda El-Shibiny, Edward Yang, Terrie E. Inder, Mohamed El-Dib
Summary: The study compared the NICHD and SIBEN assessments for neonatal encephalopathy severity, finding good agreement between the methods but SIBEN defined more infants as moderate NE. Both numerical scores were superior to standard grades in predicting MRI injury.
JOURNAL OF PERINATOLOGY
(2022)
Article
Obstetrics & Gynecology
Kullasate Sakpichaisakul, Krittin J. Supapannachart, Mohamed El-DIb, Eniko Szakmar, Edward Yang, Brain H. Walsh, Julian N. Robinson, Sara Cherkerzian, Joseph J. Volpe, Terrie E. Inder
Summary: The study found that lactate and base deficit in infant blood gas were correlated with the severity of neurological injury, while pH and aUCG in infants were not. Additionally, metabolic measures were most associated with the severity of clinical neurological examination, but not with MRI scoring.
JOURNAL OF PERINATOLOGY
(2021)
Review
Pediatrics
Oscar DeLaGarza-Pineda, Janette A. Mailo, Geraldine Boylan, Vann Chau, Hannah C. Glass, Amit M. Mathur, Renee A. Shellhaas, Janet S. Soul, Courtney J. Wusthoff, Taeun Chang
Summary: Neonatal encephalopathy is the most common cause of acute neonatal seizures, which should be identified through continuous EEG monitoring. The treatment goal is to minimize seizure burden and reduce the risk of brain injury.
SEMINARS IN FETAL & NEONATAL MEDICINE
(2021)
Article
Developmental Biology
May W. W. Chen, Jennifer K. K. Lee, Gilbert Vezina, Aylin Tekes, Jamie Perin, Ruoying Li, Alexandra O'Kane, Meaghan McGowan, Taeun Chang, Charlamaine Parkinson, Colleen Krein, Tareq Al-Shargabi, Frances J. J. Northington, Ken M. M. Brady, An N. N. Massaro, Rathinaswamy B. B. Govindan
Summary: Identifying the hemodynamic range that best supports cerebral perfusion using near infrared spectroscopy (NIRS) autoregulation monitoring is a potential physiologic marker for neonatal hypoxic-ischemic encephalopathy (HIE) during therapeutic hypothermia. However, an optimal autoregulation monitoring algorithm has not been identified for neonatal clinical medicine. Our findings suggest that the accuracy of mathematical autoregulation algorithms in detecting the risk of brain injury or death may depend on temperature and postnatal age.
DEVELOPMENTAL NEUROSCIENCE
(2022)
Article
Obstetrics & Gynecology
William Sanislow, Elizabeth Singh, Edward Yang, Terrie Inder, Mohamed El-Dib
Summary: This study challenges the necessity of cUS as a universal screening tool prior to the initiation of therapeutic hypothermia for neonatal encephalopathy. Inconsistencies were found between early cUS abnormalities and MRI findings, suggesting a need for further research on the role of cUS in patient selection for TH.
JOURNAL OF PERINATOLOGY
(2022)
Article
Pediatrics
Emily M. Herzberg, Michelle Machie, Hannah C. Glass, Renee A. Shellhaas, Courtney J. Wusthoff, Taeun Chang, Nicholas S. Abend, Catherine J. Chu, M. Roberta Cilio, Sonia L. Bonifacio, Shavonne L. Massey, Charles E. McCulloch, Janet S. Soul
Summary: Seizure severity was greater and treatment response was lower among infants born term with complicated ICH. Status epilepticus was more common in HIE with ICH compared to HIE alone.
JOURNAL OF PEDIATRICS
(2022)
Article
Pediatrics
Shavonne L. Massey, Hannah C. Glass, Renee A. Shellhaas, Sonia Bonifacio, Taeun Chang, Catherine Chu, Maria Roberta Cilio, Monica E. Lemmon, Charles E. McCulloch, Janet S. Soul, Cameron Thomas, Courtney J. Wusthoff, Rui Xiao, Nicholas S. Abend
Summary: This study compares seizure characteristics and outcomes in neonates with and without cardiopulmonary disease. The results show that neonates with cardiopulmonary disease are more likely to have EEG-only seizures and experience seizure onset later. Both groups have similar response rates to antiseizure medication, but seizures are often refractory to initial treatment. This highlights the need for optimized therapeutic strategies.
JOURNAL OF PEDIATRICS
(2022)
Article
Obstetrics & Gynecology
Eniko Szakmar, Chelsea Munster, Hoda El-Shibiny, Agnes Jermendy, Terrie Inder, Mohamed El-Dib
Summary: This study aimed to evaluate the association between hypocapnia and brain injury in infants receiving therapeutic hypothermia for neonatal encephalopathy. The results showed that in moderate-severe cases, longer duration of hypocapnia was associated with more severe brain injury on MRI. However, there was no association between hypocapnia and injury scores in mild cases.
JOURNAL OF PERINATOLOGY
(2022)
Article
Obstetrics & Gynecology
Kirsten R. Thiim, Elizabeth Singh, Srinivasan Mukundan, P. Ellen Grant, Edward Yang, Mohamed El-Dib, Terrie E. Inder
Summary: This study evaluated the utility of the 1T Embrace neonatal MRI scanner in a level III NICU. The results showed that the Embrace scans detected clinically relevant brain abnormalities and were comparable to the 3T scans in some cases.
JOURNAL OF PERINATOLOGY
(2022)
Article
Clinical Neurology
Jennifer C. Keene, Lindsey A. Morgan, Nicholas S. Abend, Sara Bates, Sarah L. Bauer Huang, Taeun Chang, Catherine J. Chu, Hannah C. Glass, Shavonne L. Massey, Betsy Ostrander, Andrea C. Pardo, Craig A. Press, Janet S. Soul, Renee A. Shellhaas, Cameron Thomas, Niranjana Natarajan
Summary: This study evaluated neonatal seizure management pathways in level IV neonatal intensive care units in the United States, finding areas of consensus such as prompt EEG confirmation of seizures and administration of intravenous benzodiazepines, but also substantial heterogeneity in optimal second-line ASM, dosing, and timing of discontinuation. Further research is needed to address these areas of variability.
PEDIATRIC NEUROLOGY
(2022)
Article
Clinical Neurology
Colleen Peyton, Olivia Girvan, Renee A. Shellhaas, Monica E. Lemmon, Elizabeth E. Rogers, Janet S. Soul, Taeun Chang, Ashley Hamlett, Courtney J. Wusthoff, Catherine J. Chu, Shavonne L. Massey, Cameron Thomas, Ronnie Guillet, Linda S. Franck, Hannah C. Glass
Summary: Children with acute provoked neonatal seizures are at risk for disability and require developmental services. The COVID-19 pandemic has disrupted the delivery of these services, potentially impacting long-term outcomes for children.
PEDIATRIC NEUROLOGY
(2022)
Article
Obstetrics & Gynecology
Mohamed El-Dib, Chelsea Munster, John Sunwoo, Sara Cherkerzian, Sarah Lee, Emily Hildrey, Tina Steele, Katherine Bell, Maria Angela Franceschini, Joseph J. Volpe, Terrie Inder
Summary: This study aims to assess the association between cerebral saturation measured by Near-Infrared Spectroscopy (NIRS) and brain injury in extremely preterm infants. The results show that infants with germinal matrix/intraventricular hemorrhage (GM/IVH) have significantly lower cerebral saturation compared to those without GM/IVH, suggesting the potential of NIRS in identifying cerebral saturation patterns associated with GM/IVH development.
JOURNAL OF PERINATOLOGY
(2022)
Article
Clinical Neurology
Ani Gok, Seha Kamil Saygili, Sebuh Kurugoglu, Sema Saltik, Nur Canpolat
Summary: This study examines the occurrence of nephrolithiasis in children with type 1 SMA and identifies hypercalciuria and high urine specific gravity as common risk factors. The study suggests that children with SMA type 1 may have an increased risk of nephrolithiasis compared to the general population.
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Glenn S. Rivera, Jesse A. Stokum, Janet Dean, Cristina L. Sadowsky, Allan J. Belzberg, Matthew J. Elrick
Summary: This study evaluated the surgical efficacy of nerve transfer surgery in patients with acute flaccid myelitis (AFM) and found that preoperative clinical and neurophysiological data play a valuable role in preoperative planning and patient selection. The postoperative outcomes demonstrated that nerve transfer surgery is an effective strategy to restore strength.
PEDIATRIC NEUROLOGY
(2024)
Review
Clinical Neurology
Tristan T. Sands, Jennifer N. Gelinas
Summary: This review explores the concept of epileptic encephalopathy (EE) in pediatric epilepsy, discussing the potential impact of epileptic activity on normal brain development and mechanisms underlying cognitive and behavioral impairments. The findings highlight the threat of epileptic activity to normal brain physiology and development.
PEDIATRIC NEUROLOGY
(2024)
Editorial Material
Clinical Neurology
Grace Gombolay, Melissa A. Walker
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Salman Rashid, Monisha Goyal, Kathryn Lalor, Khaled Al-Robaidi, Vivek Shukla, Fazlur Rahman, Manimaran Ramani
Summary: This study investigated the seizure risk in asymptomatic preterm infants with high-grade intraventricular hemorrhage who underwent long-term video electroencephalographic monitoring. The findings showed that approximately 16% of these infants had seizures, and those with seizures were younger and more likely to be remonitored.
PEDIATRIC NEUROLOGY
(2024)
Letter
Clinical Neurology
Bernadeta Zabielska, Natalia Rzewuska, Sergiusz Jozwiak
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Kelly C. Burk, Maki Kaneko, Catherine Quindipan, My H. Vu, Maritza Feliz Cepin, Jonathan D. Santoro, Michele Van Hirtum-Das, Deborah Holder, Gordana Raca
Summary: This study compared the diagnostic yields of chromosomal microarray (CMA) and epilepsy-genes sequencing (EGS) for genetic epilepsy etiologies. It found that EGS had a significantly higher diagnostic yield than CMA, especially for patients with infantile seizure onset and additional neurological findings.
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Ursula Thome, Larissa A. Batista, Renata P. Rocha, Vera C. Terra, Ana Paula A. Hamad, Americo C. Sakamoto, Antonio C. Santos, Marcelo Santos, Helio R. Machado
Summary: Rasmussen encephalitis (RE) is a characterized by pharmacoresistant epilepsy and progressive neurological deficits. Surgical disconnection of the affected hemisphere is considered the treatment of choice, although the precise etiology is still unknown. This study reports the clinical, electrographic, and neuroimaging features of children and adolescents who underwent hemispheric surgery (HS) for the treatment of RE.
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Michal Tzadok, Rotem Gur-Pollack, Hadar Florh, Yael Michaeli, Tal Gilboa, Mirit Lezinger, Eli Heyman, Veronika Chernuha, Irina Gudis, Andreea Nissenkorn, Tally Lerman-Sagie, Bruria Ben Zeev, Shimrit Uliel-Sibony
Summary: Purified CBD is well-tolerated and effective in reducing seizure frequency in children and young adults with drug-resistant epilepsy.
PEDIATRIC NEUROLOGY
(2024)
Editorial Material
Clinical Neurology
Zimeng Ye, Sufang Lin, Xia Zhao, Mathew Wallis, Xinyi Gao, Li Sun, Jiarui Wu, Jing Duan, Yi Yao, Lin Li, Li Chen, Dezhi Cao, Zhanqi Hu, Victor W. Zhang, Samuel F. Berkovic, Ingrid E. Scheffer, Jianxiang Liao, Michael S. Hildebrand
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Nicolas J. Abreu, Madeline Chiujdea, Shanshan Liu, Bo Zhang, Sarah J. Spence
Summary: This study found a low completion rate of chromosomal microarray (CMA) testing for patients with autism spectrum disorder (ASD). Provider recommendation and more follow-up visits were associated with CMA completion. Age, intellectual disability or global developmental delay, first-degree relative with ASD, and public insurance were all related to CMA completion. Parental concern and cost/insurance coverage were the most frequently documented barriers.
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Wafa Bouchaala, Sirine Laroussi, Yosra Mzid, Imen Maaloul, Olfa Jallouli, Salma Zouari, Sihem Ben Nsir, Zeineb Mnif, Fatma Kammoun, Chahnez Triki
Summary: Moyamoya angiopathy is a rare but serious cerebrovascular disease in children, which may result in arterial ischemic stroke. The clinical and radiological presentations can vary and are often overlooked. Early diagnosis and treatment are crucial.
PEDIATRIC NEUROLOGY
(2024)
Letter
Clinical Neurology
Eline M. C. Hamilton, Pinar Topaloglu, Jigyasha Sinha, Francesco Nicita, Genevieve Bernard, S. Ali Fatemi, Marjo S. van der Knaap
PEDIATRIC NEUROLOGY
(2024)
Article
Clinical Neurology
Muhamad Azamin Anuar, Muhammad'Adil Zainal Abidin, Soo Hong Tan, Cai Fong Yeap, Nor Azni Yahaya
Summary: This study conducted in Malaysia found that most infants with epilepsy can achieve seizure remission. However, poor seizure control and developmental delay are associated with abnormal EEG background and neuroimaging abnormalities.
PEDIATRIC NEUROLOGY
(2024)
