Amplitude-integrated EEG (a-EEG) time course during the first 24 hrs of life was related to brain metabolism changes detected by proton MR spectroscopy (H-MRS) at 7-10 days of post-natal life in non-cooled term newborns with hypoxic-ischemic-encephalopathy (HIE). In a study at the Neonatology Unit, University of Bologna, Italy, a-EEG at 6, 12 and 24 hrs of life in 27 of 31 patients who survived was correlated with outcome; the a-EEG showed improvement in newborns with normal H-MRS and good outcome and a deterioration in those with abnormal H-MRS and poor outcome. a-EEG time course in the first 24 hrs of life may document the severity and evolution of cerebral damage following a perinatal IH event. Both H-MRS and a-EEG show a good correlation with outcome. [1]

COMMENT. Prompt evaluation of newborns with HI encephalopathy to determine severity of brain damage and prognosis is important in therapy and follow-up. Seizure activity detected by a-EEG was associated with poor outcome only in patients with abnormal a-EEG background pattern. A normal a-EEG background at 24 hrs of life was predictive of normal outcome, a finding in agreement with that of van Rooij et al. 2005 (cited by authors), who reported that the background activity at onset of seizures is the best predictor of outcome. H-MRS shows a better correlation with outcome compared to conventional MRI. a-EEG and H-MRS have a similar sensitivity and specificity for prediction of outcome.