Continuous electroencephalography monitoring of the preterm infant

The rationale for using continuous electroencephalography (EEG) in newborn infants is to obtain information on brain function in sick term or preterm infants who may be incapable of showing symptoms of compromised brain activity. Continuous monitoring of electrocortical activity includes evaluation of overall background activity, detection of subclinical seizure activity, and verification of clinically suspected seizures. Continuous EEG monitoring has been used increasingly in neonatal intensive care units (NICU) because studies have shown that a trend measure of the EEG, the amplitude-integrated EEG (aEEG), is sensitive for very early prediction of outcome in term asphyxiated infants [1,2]. The aEEG is also increasingly being used in preterm infants, as seen in several recent studies [3-9]. Although the value of continuous EEG monitoring in preterm infants with brain injury has not been proven, some studies have shown that development of intraventricular hemorrhage (IVH) and white matter injury (WMI) is associated with early changes in the EEG as evaluated by aEEG and spectral edge frequency, which is another trend measure of the EEG [10-12].