Neuromonitoring Neonatal Intensive Care Unit cEEG Report

CLINICAL INFORMATION:

Postmenstrual age

EEG indication:

Characterize clinical events concerning for seizure

Detect electrographic-only seizures in high risk populations (i.e., neonatal encephalopathy, cardiac, or pulmonary risk factors for cerebral injury, etc.).

Assess the degree of encephalopathy

Monitor for seizure recurrence during or after weaning antiseizure medications

Neuroactive medications: Please list (i.e., antiseizure medications, morphine, etc.).

Therapeutic hypothermia: Y/N

BASELINE RECORDING: The first hour of recording was reviewed at [ ]. Electrographic seizures were/were not appreciated.

DESCRIPTION

Background Description:

Awake state: During the awake state, with eyes open, the background activity consisted of a continuous mixture of polymorphic waves varying from delta to beta range frequencies associated with muscle artifact.

Active sleep: During active sleep, respirations are irregular and eyes are closed with muscle artifact appreciated. The record during this time remains continuous. A mixed-frequency, active pattern with continuous theta to delta range activity is seen. A low-voltage, irregular pattern is at times appreciated.

Quiet sleep: During quiet sleep, eyes are closed and a tracé alternant pattern was appreciated. This consisted of bursts of up to [ ] microvolts polymorphic delta and theta activity followed by periods of relative background-voltage attenuation of up to [ ] seconds in duration. The bursts of activity were generally synchronous between the two hemispheres. Respirations during this time are regular with minimal muscle artifact appreciated on chin EMG leads. A continuous high-voltage, slow-wave pattern is also seen.

564State change: The infant cycles/does not cycle through the awake state as well as quiet and active sleep to suggest state change.

Variability: Y/N

Synchrony: Y/N

Multifocal sharp transients: List regions and comment on frequency (should primarily be seen in quiet sleep).

Normal grapho-elements: If yes, please list (i.e., encoches frontalis were present, anterior dysrhythmia was present, or delta brushes were present).

Reactivity: Tactile and auditory stimulation was performed. There was/was not EEG change appreciated suggesting the presence of reactivity.

Epileptiform Abnormalities: Y/N

Periodic Patterns: Y/N

Electrographic Seizures: Y/N

If yes:

Electrographic signature:

Typical duration:

Time of first seizure:

Time of last seizure:

Seizure burden: the number of seizures per hour or percent of record with seizures or each individual seizure duration

Percent clinical correlate:

Is there evidence of nonconvulsive status epilepticus?

If yes, how is it defined:

One continuous seizure lasting greater than 30 minutes or total duration of seizures lasting greater than 50% of a 1-hour epoch.

Events: There are/are no patient-marked events or log-reported events.

565EKG: A prolonged lead I EKG rhythm strip approximated a heart rate of [ ] beats/minute.

Activation procedures: Hyperventilation and photic stimulation were not performed.

INTERPRETATION

This EEG is abnormal due to:

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COMPARISON:

In comparison to the prior day of recording on [ ] this study is

CLINICAL CORRELATION

This EEG is consistent with

Clinical correlation is recommended.