Reference values for amplitude-integrated EEGs in children from 1 month to 17 years of age

Abstract

Aim: Amplitude-integrated electroencephalography (aEEG) is used to monitor electrocortical activity in critically ill children, but reference values are lacking for patients older than 3.5 months. We aimed to derive reference values for paediatric aEEGs from neurologically healthy children. Methods: Normal EEGs from awake children aged 1 month to 17 years (213 female, 237 male) without neurological disease or neuroactive medication were retrospectively converted into aEEGs. Two observers manually measured the upper and lower amplitude borders of the C3 - P3, C4 - P4, C3 - C4, P3 - P4, and Fp1 - Fp2 channels of the 10 - 20 system. Percentiles (10th, 25th, 50th, 75th, 90th) were calculated for each age group (< 1 year, 1 year, 2 - 5 years, 6 - 9 years, 10 - 13 years, 14 - 17 years). Results: Amplitude heights and curves differed between channels without sex-specific differences. During the first 2 years of life, upper and lower amplitudes of all but the Fp1 - Fp2 channel increased and then declined until 17 years. The decline of the upper Fp1 - Fp2 amplitude began at four years, while the lower amplitude declined from the first year of life. Interpretation: aEEG interpretation must account for age and electrode positions but not for sex in infants and children.

Amplitude Integrated Electroencephalography: Simulated Assessment of Neonatal Seizure Detection in PICU Patients

“…It has become commonly used in neonatal critical care for identification of seizures and to determine eligibility for therapeutic hypothermia in the setting of perinatal hypoxic encephalopathy (12)(13)(14). The application of aEEG to management of older children in the PICU is increasing and normative references are emerging to assist interpretation of background activities (15)(16)(17)(18)(19)(20). However, the criteria by which neonatal seizures are recognized by aEEG have not been tested in older children.…”