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Treatment Effects on Neonatal EEG

Obeid, Rawad; Tsuchida, Tammy N.

Journal of Clinical Neurophysiology: October 2016 - Volume 33 - Issue 5 - p 376–381
doi: 10.1097/WNP.0000000000000300
Invited Review

Summary: Conventional EEG and amplitude-integrated electroencephalography are used in neonates to assess prognosis and significant changes in brain activity. Neuroactive medications and hypothermia can influence brain activity and therefore alter EEG interpretation. There are limited studies on the effect of these therapies on neonatal EEG background activity. Medication effects on the EEG or amplitude-integrated electroencephalography include increased interburst interval duration, voltage suppression, and sleep disruption. The effect is transient in term newborns but can be persistent in premature newborns. Although therapeutic hypothermia does not produce significant changes in EEG activity, it does change the time point at which EEG can accurately predict neurodevelopmental outcome. It is important to account for these effects on the EEG to avoid inaccurate interpretation that may affect prognostication.

Department of Neurology, Children's National Health System, Washington, District of Columbia, U.S.A.

Address correspondence and reprint requests to Rawad Obeid, MD, Department of Neurology, Children's National Health System, 111 Michigan Avenue, North West, Washington, DC 20010, U.S.A.; e-mail:

The authors declare no conflicts of interest.

© 2016 by the American Clinical Neurophysiology Society