Electroencephalography in Infants With Periventricular Leukomalacia: Prognostic Features at Preterm and Term Age

Abstract

Cystic periventricular leukomalacia represents the most severe white-matter lesion in preterm infants and its occurrence accounts for most cases of neurologic impairment in these subjects. Electroencephalographic (EEG) findings and their prognostic value in relation to motor and cognitive outcome were investigated in a group of preterm infants affected by different degrees of cystic periventricular leukomalacia. EEG recordings were carried out in the early postnatal period (first 2 weeks of life) on 24 infants and at term age on 29. In the early postnatal period, background EEG abnormalities ("dysmaturity") were significantly more apparent in affected infants than in a control group, and, among infants with cystic periventricular leukomalacia, this parameter related to the occurrence of cerebral palsy; moreover, at the same age, the incidence of abnormal EEG transients seemed to show a correlation with cognitive outcome. At term age, these latter abnormalities were significantly more apparent in neonates with cystic periventricular leukomalacia than in control subjects, but they did not show any prognostic value. In conclusion, these data indicate that, during the early postnatal period, the EEG is a useful diagnostic and prognostic tool for preterm infants with white-matter lesions, whereas at term age, the role of EEG tracings appears secondary. (J Child Neurol 2000;15:1-6)

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References

Volpe JJ : Neurology of the Newborn, 3rd ed. Philadelphia, WB Saunders, 1995.

de Vries LS , Eken P. , Dubowitz LMS: The spectrum of leukomalacia using cranial ultrasound. Behav Brain Res 1992;49:1-6.

de Vries LS , Regev R. , Pennock JM , et al: Ultrasound evolution and later outcome of infants with periventricular densities. Early Hum Dev 1988;16:225-233.

Blume WT , Dreyfus-Brisac C: Positive rolandic sharp waves in neonatal EEG: Types and significance. Electroencephalogr Clin Neurophysiol 1982;53:277-282.

Chung HJ , Clancy RR: Significance of positive temporal sharp waves in the neonatal electroencephalogram . Electroencephalogr Clin Neurophysiol 1991 ;79:256-263.

Marret S. , Parain D. , Jeannot E. , et al: Positive rolandic sharp waves in the EEG of the premature newborn: A five-year prospective study. Arch Dis Child 1992;67:948-951.

Novotny EJ , Tharp BR , Coen RW , et al: Positive rolandic sharp waves in the EEG of the premature infant . Neurology 1987;37: 1481-1486.

Nowack WJ , Janati A. , Angtuaco T: Positive temporal sharp waves in neonatal EEG. Clin Electroencephalogr 1989;20:196-201.

Vecchierini-Blineau MF , Nguyen The Tich S. , Debillon T. , et al: Severe periventricular leukomalacia: Characteristic electroencephalographic features . Neurophysiol Clin 1996;26:102-108.

10.

Biagioni E. , Boldrini A. , Bottone U. , et al: Prognostic value of abnormal EEG transients in preterm and full-term neonates. Electroencephalogr Clin Neurophysiol 1996;99:1-9.

11.

Biagioni E. , Bartalena L. , Biver P. , et al: Electroencephalographic dysmaturity in preterm infants: A prognostic tool in the early postnatal period. Neuropediatrics 1996;27:311-316.

12.

Biagioni E. , Bartalena L. , Boldrini A. , et al: Background EEG activity in preterm infants: Correlation of outcome with selected maturational features. Electroencephalogr Clin Neurophysiol 1994; 91:154-162.

13.

Connell J. , Oozeer R. , Regev R. , et al: Continuous four-channel EEG monitoring in the evaluation of echodense ultrasound lesions and cystic leukomalacia. Arch Dis Child 1987;62:1019-1024.

14.

Itakura A. , Kurauchi O. , Hayakawa F. , et al: Timing of periventricular leukomalacia using neonatal electroencephalography . Int J Gynaecol Obstet 1996;55:111-115.

15.

Murdoch-Eaton DG , Wertheim D. , Oozeer R. , et al: Reversible changes in cerebral activity associated with acidosis in preterm neonates. Acta Paediatr 1994;83:486-492.

16.

van Sweden B. , Koenderink M. , Windau G. , et al: Long term EEG monitoring in the early premature: Developmental and chronobiological aspects. Electroencephalogr Clin Neurophysiol 1991-179: 94-100.

17.

Cioni G. , Bartalena L. , Biagioni E. , et al: Neuroimaging and functional outcome of neonatal leukomalacia . Behav Brain Res 1992;49:7-19.

18.

Karch D. , Rohmer K. , Lemburg P: Prognostic significance of poly-graphic recordings in newborn infants on ventilation . Dev Med Child Neur 1984;26:358-368.

19.

Marret S. , Parain D. , Ménard JF , et al: Prognostic value of neonatal electroencephalography in premature newborns less than 33 weeks of gestational age. Electroencephalogr Clin Neurophysiol 1997;102:178-185.

20.

Radvanyi-Bouvet MF , De Bethmann O. , Monset-Couchard M. , Fazzi E: Cerebral lesions in early prematurity: EEG prognostic value in the neonatal period. Brain Dev 1987;9:399-405.

21.

Tharp BR , Cukier F. , Monod N: The prognostic value of the electroencephalogram in premature infants. Electroencephalogr Clin Neurophysiol 1981;51:219-236.

22.

World Health Organization : International Classification of Impairments, Disabilities and Handicaps. Geneva, World Health Organization, 1980.

23.

Cioni G. , Paolicelli PB , Sordi C. , Vinter A. : Sensorimotor development in cerebral palsied infants assessed with the Uzgiris-Hunt scales. Dev Med Child Neurol 1993;35:1055-1066.

24.

Griffiths R. : The Abilities of Babies. London, University of London Press, 1954.

25.

Uzgiris IC , Hunt JM :. Assessment in Infancy: Ordinal Scales of Psychological Development. Urbana, University of Illinois Press, 1975.

26.

Graziani LJ , Pasto M. , Stanley C. , et al: Neonatal neurosonographic correlates of cerebral palsy in preterm infants. Pediatrics 1986;78: 88-95.

27.

Pidcock FS , Graziani LJ , Stanley C. , et al: Neurosonographic features of periventricular echodensities associated with cerebral palsy in preterm infants. J Pediatr 1990;116:417-422.

28.

Hayakawa F. , Okumura A. , Kato T. , et al: Disorganized patterns: Chronic-stage EEG abnormality of the late neonatal period following severely depressed EEG activities in early preterm infants. Neuropediatrics 1997;28:272-275.

29.

Aso K. , Barmada MA , Scher MS: EEG and the neuropathology in premature neonates' intraventricular haemorrhage . J Clin Neurophysiol 1993;10:304-313.

30.

Scher MS , Bova JM , Dokianakis SG , Steppe DA: Physiological significance of sharp wave transients on EEG recording of healthy pre-term and full-term neonates. Electroencephalogr Clin Neurophysiol 1994;90:179-185.

31.

Pezzani C. , Radvanyi-Bouvet MF , Relier JP , Monod N: Neonatal electroencephalography during the first twenty-four hours of life in full-term newborn infants. Neuropediatrics 1986;17: 11-18.

32.

Volpe JJ Brain injury in the premature infant: From pathogenesis to prevention. Brain Dev 1997;19:519-534.

33.

de Vries LS , Eken P. , Groenendaal F. , et al: Antenatal onset of haemorrhagic and/or ischaemic lesions in preterm infants: Prevalence and associated obstetric variables. Arch Dis Child Fetal Neonatal Ed 1998;78:F51-F56.