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Reevaluation of neonatal EEGs and polygraphic tracings of 40 infants with infantile
spasms and/or hypsarrhythmia resulted in the constitution of a compound score for
the identification of infants at risk for infantile spasms by neonatal EEG. The score
comprises 8 distinct items: 2 concern behavioral characteristics, 6 abnormality of
EEG background activity and paroxysmal events. A tracing registered at conceptional
age 36 to 44 weeks (eventually up to 50 weeks) presenting at least 4 of these 8 items
is scored positive for the risk of evolving hypsarrhythmia.
In a prospective study the polygraphic tracings of 941 newborn infants were evaluated
for risk: 18 infants suffering from perinatal distress and 7 newborns with malformations
of the brain were scored positive and all 25 developed infantile spasms and/or hypsarrhythmia.
One infant with later infantile spasms was missed by the scoring system. None of the
remaining infants scored negative manifested infantile spasms. Thus, correct positive
prognostication was 100% and false negative 0.1%. By conventional EEG 5 out of 8 patients
with infantile spasms were correctly predicted.
The high validity of the risk-score based on polygraphic tracing between conceptional
age 36 to 44 weeks may allow pre-onset treatment preventing secondary mental deterioration
due to hypsarrhythmia and infantile spasms.
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Article info
Footnotes
1To Prof. H. Doose on behalf of his 60th birthday
Identification
Copyright
© 1987 Published by Elsevier Inc.