Seizures and hypothermia: Importance of electroencephalographic monitoring and considerations for treatment

Boylan, Geraldine B.; Kharoshankaya, Liudmila; Wusthoff, Courtney J.

doi:10.1016/j.siny.2015.01.001

Cited by 55 publications

(35 citation statements)

References 49 publications

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“…Hypothermia might have an anticonvulsant effect by inhibiting the release of glutamate and free oxygen Non-cooled patients (n=33) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 Patients Patients 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 0 2 radicals, and reducing cytotoxic oedema through a lower release of aminaocides. 2 Although amplitude-integrated EEG is useful for cooling recruitment, it is not as accurate as pEEG for diagnosing seizures and for defining seizure incidence and burden. Randomized trials, based on clinical and/or amplitude-integrated EEG monitoring, show an unchanged incidence of seizures during hypothermia.…”

Section: Discussionmentioning

confidence: 99%

“…3,4 Animal studies have shown a reduction in amplitude and extent of seizures, 3,4 whereas in humans the data are inconclusive. 2,18,19 Because pEEG represents the criterion standard for diagnosing and monitoring neonatal seizures, studies based on this technique are desirable. 2 Although amplitude-integrated EEG is useful for cooling recruitment, it is not as accurate as pEEG for diagnosing seizures and for defining seizure incidence and burden.…”

Section: Discussionmentioning

confidence: 99%

“…Although an adverse outcome is related to brain injury secondary to hypoxia-ischemia, previous studies have suggested that seizures exacerbate the primary injury and are themselves harmful to the developing brain. 2 However, all the pEEG-based studies comparing cooled and non-cooled newborn infants have concluded that hypothermia reduces seizure incidence [5][6][7] and burden. Monitoring with cotside polygraphic electroencephalography (pEEG) is the most accurate method for recording seizure burden and quantifying it offline, although pEEG is rarely used in neonatal intensive care units.…”

mentioning

confidence: 99%

“…Monitoring with cotside polygraphic electroencephalography (pEEG) is the most accurate method for recording seizure burden and quantifying it offline, although pEEG is rarely used in neonatal intensive care units. 2 Experimental and clinical studies have demonstrated that hypothermia after hypoxia-ischemia reduces the extent of brain injury. As a result, hypothermia has emerged as the standard of care for HIE.…”

mentioning

confidence: 99%

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Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic–ischemic encephalopathy: an observational study

Guidotti¹,

Lugli²,

Guerra³

et al. 2016

Develop Med Child Neuro

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 2 more Smart Citations

Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic–ischemic encephalopathy: an observational study

Guidotti¹,

Lugli²,

Guerra³

et al. 2016

Develop Med Child Neuro

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show abstract

“…Reported incidences of neonatal seizures that are subclinical vary widely [19]; it is estimated that electrographic seizures account for the majority (up to 90%) of neonatal seizures, especially during TH [20, 21]. Therefore, it might have been expected that the higher sensitivity and specificity of recent cEEG protocols and more frequent EEG monitoring would result in a higher number of diagnosed seizures and more ASDs being prescribed.…”

Section: Discussionmentioning

confidence: 99%

EEG Monitoring Technique Influences the Management of Hypoxic-Ischemic Seizures in Neonates Undergoing Therapeutic Hypothermia

et al. 2017

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Electroencephalogram (EEG) monitoring techniques for neonatal hypoxia-ischemia (HI) are evolving over time, and the specific type of EEG utilized could influence seizure diagnosis and management. We examined whether the type of EEG performed affected seizure treatment decisions (e.g., the choice and number of antiseizure drugs [ASDs]) in therapeutic hypothermia-treated neonates with HI from 2007 to 2015 in the Johns Hopkins Hospital Neonatal Intensive Care Unit. During this period, 3 different EEG monitoring protocols were utilized: Period 1 (2007-2009), single, brief conventional EEG (1 h duration) at a variable time during therapeutic hypothermia treatment, i.e., ordered when a seizure was suspected; Period 2 (2009-2013), single, brief conventional EEG followed by amplitude-integrated EEG for the duration of therapeutic hypothermia treatment and another brief conventional EEG after rewarming; and Period 3 (2014-2015), continuous video-EEG (cEEG) for the duration of therapeutic hypothermia treatment (72 h) plus for an additional 12 h during and after rewarming. One hundred and sixty-two newborns were included in this retrospective cohort study. As a function of the type and duration of EEG monitoring, we assessed the risk (likelihood) of receiving no ASD, at least 1 ASD, or ≥2 ASDs. We found that the risk of a neonate being prescribed an ASD was 46% less during Period 3 (cEEG) than during Period 1 (brief conventional EEG only) (95% CI 6-69%, p = 0.03). After adjusting for initial EEG and MRI results, compared with Period 1, there was a 38% lower risk of receiving an ASD during Period 2 (95% CI: 9-58%, p = 0.02) and a 67% lower risk during Period 3 (95% CI: 23-86%, p = 0.01). The risk ratio of receiving ≥2 ASDs was not significantly different across the 3 periods. In conclusion, in addition to the higher sensitivity and specificity of continuous video-EEG monitoring, fewer infants are prescribed an ASD when undergoing continuous forms of EEG monitoring (aEEG or cEEG) than those receiving conventional EEG. We recommend that use of continuous video-EEG be considered whenever possible, both to treat seizures more specifically and to avoid overtreatment.

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A new lossless electroencephalogram compression technique for fog computing‐based IoHT networks

Idrees

Khlief

2023

Int J Communication

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SummaryThe ability to design smarter, more predictive healthcare solutions for use in the community (at work and at home) and in healthcare facilities has been greatly enhanced by recent developments in the Internet of Health Things (IoHT) and cyber physical systems (CPS). These data collected by such medical sensors will be sent in a large quantity to the fog gateway of IoHT networks. These data should be forwarded to far cloud for further analysis and processing. Therefore, sending all of these data over the IoHT network to the data center will impose a significant burden on the IoHT network. This paper proposed a new lossless electroencephalogram (EEG) compression technique (NeLECoT) for fog computing‐based IoHT networks. It encodes the data of the patient at the fog gateway prior to sending it to the data center, thereby reducing the data's size. In the fog node, the NeLECoT combines three efficient techniques: clustering based on density‐based spatial clustering of applications with noise (DBSCAN), RLE (run length encoding), and Huffman encoding (HE). The clustering based on DBSCAN separates a massive volume of captured data into small groups of closely related (or similar) data. RLE encodes clustered EEG data, and the resulting file is encoded with HE. The fog gateway then transmits the encoded file to the cloud. Numerous simulation experiments were carried out, and the findings demonstrated that the suggested NeLECoT achieved better results than the competing techniques in terms of transmitted data size, compression ratio, compression power, compression time, decompression time, and average compression power.

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Seizures and hypothermia: Importance of electroencephalographic monitoring and considerations for treatment

Cited by 55 publications

References 49 publications

Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic–ischemic encephalopathy: an observational study

Hypothermia reduces seizure burden and improves neurological outcome in severe hypoxic–ischemic encephalopathy: an observational study

EEG Monitoring Technique Influences the Management of Hypoxic-Ischemic Seizures in Neonates Undergoing Therapeutic Hypothermia

A new lossless electroencephalogram compression technique for fog computing‐based IoHT networks

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