Treating EEG seizures in hypoxic ischemic encephalopathy: A randomized controlled trial

Preethi Srinivasakumar, John Zempel, Shamik Trivedi, Michael Wallendorf, Rakesh Rao, Barbara Smith, Terrie Inder, Amit M. Mathur

Research output: Contribution to journalArticle

47 Citations (Scopus)

Abstract

BACKGROUND: The impact of treating electrographic seizures in hypoxic ischemic encephalopathy (HIE) is unknown. METHODS: Neonates $36 weeks with moderate or severe HIE were randomly assigned to either treatment of electrographic seizures alone (ESG) or treatment of clinical seizures (CSG). Conventional EEG video was monitored in both groups for up to 96 hours. Cumulative electrographic seizure burden (SB) was calculated in seconds and converted to log units for analysis. MRI scans were scored for severity of brain injury. Infants underwent neurodevelopmental evaluation at 18 to 24 months. Statistical analyses were performed by using SAS 9.3 version (SAS Institute, Inc, Cary, NC). RESULTS: Thirty-five of 69 neonates (51%) who were randomly assigned and included in the study developed seizures (15 in ESG and 20 in CSG). Excluding infants with status epilepticus, median SB (interquartile range) in seconds in ESG (n = 10) was lower than in CSG (n = 16) (449 [113-2070] vs 2226 [760-7654]; P =.02). ESG had fewer seizures with shorter time to treatment (P =.04). Twenty-four of 30 (80%) surviving infants with seizures underwent neurodevelopmental evaluation at 18 to 24 months. Increasing SB in the combined cohort was significantly associated with higher brain injury scores (P

Original languageEnglish (US)
Pages (from-to)e1302-e1309
JournalPediatrics
Volume136
Issue number5
DOIs
StatePublished - Nov 1 2015

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Brain Hypoxia-Ischemia
Electroencephalography
Seizures
Randomized Controlled Trials
Brain Injuries
Newborn Infant
Status Epilepticus
Therapeutics
Magnetic Resonance Imaging

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Srinivasakumar, P., Zempel, J., Trivedi, S., Wallendorf, M., Rao, R., Smith, B., ... Mathur, A. M. (2015). Treating EEG seizures in hypoxic ischemic encephalopathy: A randomized controlled trial. Pediatrics, 136(5), e1302-e1309. https://doi.org/10.1542/peds.2014-3777

Treating EEG seizures in hypoxic ischemic encephalopathy : A randomized controlled trial. / Srinivasakumar, Preethi; Zempel, John; Trivedi, Shamik; Wallendorf, Michael; Rao, Rakesh; Smith, Barbara; Inder, Terrie; Mathur, Amit M.

In: Pediatrics, Vol. 136, No. 5, 01.11.2015, p. e1302-e1309.

Research output: Contribution to journalArticle

Srinivasakumar, P, Zempel, J, Trivedi, S, Wallendorf, M, Rao, R, Smith, B, Inder, T & Mathur, AM 2015, 'Treating EEG seizures in hypoxic ischemic encephalopathy: A randomized controlled trial', Pediatrics, vol. 136, no. 5, pp. e1302-e1309. https://doi.org/10.1542/peds.2014-3777
Srinivasakumar, Preethi ; Zempel, John ; Trivedi, Shamik ; Wallendorf, Michael ; Rao, Rakesh ; Smith, Barbara ; Inder, Terrie ; Mathur, Amit M. / Treating EEG seizures in hypoxic ischemic encephalopathy : A randomized controlled trial. In: Pediatrics. 2015 ; Vol. 136, No. 5. pp. e1302-e1309.
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