How is the neonatal electroencephalogram (EEG) record classified?

Updated: Aug 20, 2019
  • Author: Samuel Koszer, MD; Chief Editor: Selim R Benbadis, MD  more...
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Answer

Answer

Classification of the record as normal or abnormal is the most important step in interpreting a neonatal record. [10, 11, 12] If the record is abnormal, a list of abnormal features is reported.

Impression takes into account the classification made, abnormal features, and patient's history (including use of medications and findings prior to EEG testing). Even in neonates, barbiturates and benzodiazepines may cause diffuse beta activity and should not be interpreted as a seizure or abnormal record.

Follow-up examinations may be suggested if the examination is technically difficult or technically unsatisfactory, maturation of the neonate is inconsistent with the EEG findings, or results of therapeutic interventions are analyzed.

Table 2. Interpretation of the Neonatal EEG (Open Table in a new window)

Classification of Features

Impression

Normal features

Normal for gestational age

Immature pattern

Cerebral dysfunction or gestational age not calculated correctly

Multifocal abnormalities

Multifocal or diffuse cerebral dysfunction

Background abnormalities

Multifocal or diffuse cerebral dysfunction

Focal abnormalities

Focal cerebral dysfunction

Electrographic seizures

Focal or multifocal epileptogenic regions

Prognosis based on EEG findings may also be helpful to relay in the impression. For a description of prognostication see the reference by Holmes and Lombroso. [13]


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