Seizures are the most frequent neurological event in newborn infants, with an estimated incidence of 10.3/1000 live births. Neonates who experience seizures have an increased risk of mortality as well as long-term neurodevelopmental morbidities including epilepsy, cerebral palsy, developmental delay, and psychomotor deficits, among others. Although frequent, the recognition of seizures in the neonate can be challenging. Electroencephalography (EEG) is one of the most valuable noninvasive monitoring tools in the neonatal intensive care unit, providing information about brain dynamics as well as cerebral disorders. EEG is widely used in neonatal intensive care units to continuously monitor brain function and is a useful tool for the detection of neonatal seizures. Over 50% of the seizures that occur in neonates are subclinical and associated with poor outcomes. Therefore, early identification of seizures allows for prompt treatment and potentially improved outcomes in this population. One of the primary responsibilities of nurses and telemetry technicians caring for critically ill neonates is the early identification of seizure activity. In order to effectively identify seizures by utilizing EEG monitoring, these healthcare providers must be knowledgeable about, and skilled in, the identification of EEG abnormalities.
An educational need has been identified for a continuing education activity on EEG monitoring critically ill neonates for seizures. Specifically, this activity will discuss the importance of recognizing seizures in neonates, review the basics of EEG monitoring, and review normal EEG patterns as well as abnormal EEG patterns associated with seizures. This one-hour online continuing education activity is recommended for nurses and telemetry technicians.
Seizures are the most frequent neurological event in newborn infants and neonates who experience seizures have an increased risk of mortality as well as long-term neurodevelopmental morbidities. Although frequent, the recognition of seizures in the neonate can be challenging. Electroencephalography (EEG) is one of the most valuable noninvasive monitoring tools in the neonatal intensive care unit, providing information about brain dynamics as well as cerebral disorders. This activity will assist nurses and telemetry technicians improve practice regarding EEG monitoring for seizures by reviewing abnormal EEG findings associated with seizures.
Learning Outcome / Objectives
After completing this continuing education activity, nurses and telemetry technicians will be able to use continuous EEG to monitor neonatal patients for seizures. Specifically, they will be able to (1) cite the clinical importance of recognizing EEG abnormalities associated with seizures and (2) identify the abnormal features of EEG associated with seizures in neonatal patients.
- Neonatal Seizures
- Incidence and consequences
- Risk factors
- Challenges for recognition
- Classification of seizures
- EEG Monitoring Basics
- Standard versus amplitude integrated EEG
- Electrode placement
- Duration of monitoring
- EEG review, interpretation, and reporting
- Normal EEG Patterns
- Continuity and discontinuity
- Developmental hallmarks (brushes, sharps, bursts)
- Abnormal EEG Findings – Seizures
- Abnormal features
- Seizure characteristics (duration, location, morphology, evolution, semiology)
- Differentiating seizure from artifact