Neuromonitoring bei zerebralen Anfällen im Neugeborenenalter – Chancen und Herausforderungen

 

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Angesichts der vielen Kinder mit neonatalen Risikofaktoren für erworbene ZNS-Läsionen und zerebrale Anfälle ist das EEG zunehmend relevant für eine optimierte Diagnostik und Therapieüberwachung [1] [2]. Folgender Artikel gibt einen Überblick über Besonderheiten des neonatalen EEG und über aktuelle Empfehlungen zum Stellenwert des Langzeit-EEG-Monitorings bei neonatalen Anfällen und epileptischen Enzephalopathien im Früh- und Neugeborenalter.

Abstract

Neonatal EEG-monitoring including amplitude-integrated EEG (aEEG) is a valuable bedside tool for diagnosis of epileptic seizures and neonatal epileptic encephalopathies, as well as for continuous treatment monitoring. Because of methodical limitations of aEEG monitoring, the combinatory use of aEEG and conventional EEG is recommended as the gold standard. Especially physiological EEG maturation patterns and epileptic discharges (e. g. discharges<10 s, electrographic seizures in very preterm neonates) are exclusively identified by conventional EEG. Long-term EEG/aEEG monitoring is of special significance in neonates at risk of “electrographic-only” or subtle seizures. EEG/aEEG is an important additional tool for monitoring neonates with HIE undergoing therapeutic hypothermia. Rarely, typical EEG changes indicative of a genetic variant have been characterized. Further studies are necessary on the role of EEG/aEEG as biomarker of neurodevelopmental outcome in neonates with seizures of various etiology.

Publication History

Article published online:
13 September 2021

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