2013, Number 4
<< Back Next >>
Acta Pediatr Mex 2013; 34 (4)
Burst-suppression pattern in the electroencephalogram of newborns and infants. Its clinical expression
Cervantes-Blanco JM, Ruiz–García M, García–Briseño A, Hernández–Antúnez BG, Díaz–García L
Language: Spanish
References: 19
Page: 180-188
PDF size: 756.08 Kb.
ABSTRACT
Burst-suppression pattern in the electroencephalogram (EEG) is associated with severe brain damage and has a bad prognosis in 85% of the cases.
Objectives. To identify the prevalence of the EEG burst-suppression pattern (BSP) in fullterm newborns and infants, determine its etiology, clinical features and course.
Methods. A retrospective study was conducted. Between January 2008 and December 2012, 4,891 EEGs were reviewed. The EEGs of newborns and infants (‹ 3 months of age) with BSP were selected.
Results. 11 cases identified with burst suppression pattern. The overall prevalence of which was 3.5%; 8.1% among the newborns and 1.2% among infants. Seizures were the main reason for doing an EEG in the newborn period in 7 patients and after day 28 in three. The clinical manifestations were abnormal level of consciousness (n=8), hypotonia (n=2), and spasticity (n=6). The main causes were hypoxic ischemic injury, stroke and kernicterus. There were two cases of early infantile epileptic encephalopathy. Two patients died before the third month of age; 8 survived an average of 13 months. All had epilepsy, neurologic retardation and disability. Two patients had persistent EEG burst-suppression pattern; 1 and 3 months after the neonatal period respectively; 7 had focal spikes and an asymmetric pattern.
Conclusions. Electroencephalographic burst-suppression pattern predicts a severe neurologic injury in fullterm newborns and infants.
REFERENCES
Martínez-Bermejo A, Roche C, López-Martín J, Tendero A. Trazado EEG neonatal de salva-supresión. Factores etiológicos y evolutivos. Rev Neurol. 2001;33(6):514-8.
Grigg-Damberger MM, Coker SB, Halsey CL, Anderson CL. Neonatal Burst Suppression: Its Developmental Significance. Pediatr Neurol. 1989;5:94-102.
Noachtar S, Binnie C, Ebersole J, Mauguière T, Sakamoto A, Westmoreland B. A glossary of terms most commonly used by clinical electroencephalographers and proposal for the report form for the EEG findings. En: Deuschl G and Eisen A. Recommendations for the Practice of Clinical Neurophysiology: Guidelines of the International Federation of Clinical Physiology (EEG Suppl 52), International Federation of Clin Neurophysiology: Elsevier Science; 1999.
Menache CC, Bourgeouis BFD, Volpe JJ. Prognostic Value of Neonatal Discontinuos EEG. Pediatr Neurol. 2002;27:93-101.
Douglass LM, Wu JY, Rosman P, Safstrom CE. Burst Suppression Electroencephalogram Pattern in the Newborn: Predicting the Outcome. J Child Neurol. 2002;17:403-308.
Ohtahara S, Yamatogi Y. Epileptic Encephalopathies in Early Infancy With Suppression-Burst. J Clin Neurophysiol. 2003;20(6):398-467.
Commission on Classification and Terminology of the International League Against Epilepsy. Proposal for revised classification of epilepsies and epileptic syndromes. Epilepsia. 1989;30:389-99.
Nunes ML, Giraldes MM, Pinho AP, Costa da Costa J. Prognostic Value of Non-reactive Burst Suppression EEG Pattern Associated to Early Neonatal Seizures. Arq Neuropsiquiatr. 2005;63(1):14-19.
Pedley TA, Ebersole JS. Current Practice of Clinical Electroenephalography. 3a edición; Philadelphia PA, EUA: Lippincott Williams & Wilkins; 2003. p. 199.
Amzica F. Basic physiology of burst-suppression. Epilepsia. 2009;50(Suppl 12):38-9.
Biagioni E, Bartalena L, Boldrini A, Pieri R, Cioni G. Constantly discontinuos EEG patterns in full-term neonates with hypoxic-ischaemic encephalopathy. Clin Neurophysiol. 1999;110:1510-15.
Niedermeyer E, Lopes Da Silva F. Electroencephalography. Basic Principles, Clnical Applications, and Related Fields. 4a edición; Baltimore, Maryland, EUA: Lippincott Williams & Wilkins; 1999. p. 919.
Volpe J. Neurología del recién nacido. 4ª edición, México, D.F.: Mc Graw-Hill Interamericana; 2003. p. 189-223.
Posner J, Saper C, Schiff N, Plum F. Plum and Posner’s Diagnosis of Stupor and Coma. 4a edición; New York, New York: Oxford; 2007. p. 3-37.
Yamatogui Y, Ohtahara S. Early-infantile epileptic encephalopathy with suppression-bursts, Ohtahara syndrome; its overview referring to our 16 cases. Brain & Develop. 2002;24:13–23.
Mikati MA. Neonatal Seizures. En: Kliegman: Nelson Textbook of Pediatrics, 19a ed. Elsevier Saunders; 2011. p. 2033-7.
Kaplan M, Wong RJ, Sibley E, Stevenson D. Neonatal jaundice and liver disease. En: Martin: Fanaroff and Martin´s Neonatal Perinatal Medicine. 9ª ed. Ed. Elsevier-Mosby; 2010. p. 1443–96.
Ambalavanan N, Carlo WA. Jaundice and Hyperbilirrubinemia in the newborn. en Kliegman: Nelson Textbook of Pediatrics. 19a edición. Elsevier Saunders; 2011. p. 600-14.
Holmes GL, Lombroso CT. Prognostic Value of Background Patterns in the Neonatal EEG. J Clin. Neurophysiol. 1993;10(3):1993.