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Question 1 Is cerebral function monitoring as accurate as conventional EEG in the detection of neonatal seizures?
  1. Sagarika Ray
  1. Correspondence to Dr Sagarika Ray, Department of Paediatrics, Northampton General Hospital, UK; sagarikaray{at}hotmail.com

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Scenario

A term baby girl is admitted to the neonatal unit following concerns regarding abnormal movements noted on the postnatal ward. She is reported to have had tonic posturing of the limbs and back-arching at 10 h of age. As the neonatal registrar on the night shift, you are asked to review the baby and you wonder whether cerebral function monitoring (CFM) of the baby would be an effective and accurate method of detecting seizure activity.

Structured clinical question

Is CFM or amplitude EEG (aEEG) [index test] as accurate as conventional EEG (cEEG) [comparison] in detecting seizures [outcome] in term neonates [population]?

Search strategy

Primary sources

A search of the EMBASE and MEDLINE healthcare databases (limits: publication year 1974–current and English language) identified 42 articles (search performed March 2010).

The following search keywords were used: [(neonat* OR newborn* OR infant*) AND (cerebral function monitor* OR electroencephalogra* OR amplitude EEG OR conventional EEG OR aEEG OR cEEG) AND (seizure* OR convulsion*)].ti

Secondary sources

No systematic reviews were identified from a search of the Cochrane Library.

Outcome

Five relevant studies were identified (see table 1).1,,5These studies included sample groups, investigations and outcome measures which were relevant to our original question. All five studies were diagnostic test comparison studies which statistically compared the sensitivity of seizure detection and interobserver agreement of aEEG with cEEG in term or near-term (at least 34 weeks' gestation) neonates with hypoxic ischaemic encephalopathy, suspected clinical seizures or at risk of seizures due to hypoxic events, meningitis …

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