The value of standard and ambulatory electroencephalography in the prediction of continuing neonatal seizures was investigated in the Department of Neurology, State University of New York, Buffalo, NY. Thirteen neonates with seizures occurring after 7 days of age were evaluated with standard short-term electroencephalography (SEEG) during the initial seizures and with ambulatory EEG (AEEG) when each infant was within 37-44 weeks corrected age (i.e., gestational age plus chronologic age). The etiology of the seizures was hypoxia in 7, infectious in 3, and idiopathic in the remainder. The occurrence of seizures at 3-4 months corrected age was accurately predicted by SEEGs in 8 of 13 cases, by AEEGs in 10 to 13, and with the combined use of SEEG and AEEG in 12 of 13. The combined analysis of SEEG and AEEG provided the best prediction of continued seizure activity in infants with neonatal seizures. [1]

COMMENT The identification of high risk infants who require antiepileptic drugs beyond the neonatal period should be facilitated by using this technique. Neonatal seizures become recurrent in approximately 25% of cases.