Features of electrophysiological activity in a neonate with severe post-hypoxic brain damage (post-hypoxic cerebral depression)
- Authors: Melashenko T.V.1, Fomina M.Y.1, Palchik A.B.1, Pavlova O.I.1
-
Affiliations:
- St. Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation
- Issue: Vol 11, No 6 (2020)
- Pages: 13-20
- Section: Original studies
- URL: https://journals.rcsi.science/pediatr/article/view/64733
- DOI: https://doi.org/10.17816/PED11613-20
- ID: 64733
Cite item
Abstract
The article briefly presents the literature data and a description of the clinical dynamic observation of a patient with severe hypoxic brain damage (from the neonatal period to 4 months of life), in the conditions of the neonatal intensive care unit. The article describes the clinical picture, features of paroxysmal states and antiepileptic therapy, dynamics of neuroimaging data, electroencephalographic phenomena recorded in a patient with cerebral depression and structural cerebral injuries. The significance of electroencephalographic examination in the intensive care unit as an informative method for assessing cerebral activity in young children with central nervous system depression syndrome is shown. Disorganization of background activity, indicating structural cerebral damage, long-term persistence of slow-wave activity, detection of epileptic changes in the form of generalized flashes of pointed waves in the theta range, alpha-coma pattern, subsequently replaced by suppression of the background pattern in the patient, are typical electrophysiological disorders recorded in severe hypoxic encephalopathy. In conditions of limited opportunities for visual diagnosis of a patient with impaired consciousness, EEG remains the only method of obtaining information about the functional state of the brain, the data obtained during the study are an important prognostic criterion.
Full Text
##article.viewOnOriginalSite##About the authors
Tatiana V. Melashenko
St. Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation
Author for correspondence.
Email: melashenkotat@mail.ru
MD, PhD, Resident doctor, Neonatal intensive care unit
Russian Federation, St. PetersburgMaria Y. Fomina
St. Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation
Email: myfomina@mail.ru
MD, PhD, Dr. Sci. (Med.), Professor, Department Neonatology with Courses in Neurology and Obstetrics-Gynecologiya
Russian Federation, St. PetersburgAlexander B. Palchik
St. Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation
Email: xander57@mail.ru
MD, PhD, Dr. Sci. (Med.), Professor, Department Neonatology with Courses in Neurology and Obstetrics-Gynecologiya
Russian Federation, St. PetersburgOlga I. Pavlova
St. Petersburg State Pediatric Medical University Ministry of Health of the Russian Federation
Email: eegenmg@mail.ru
Resident Doctor, Department of Functional Diagnostics
Russian Federation, St. PetersburgReferences
- Жирмунская Е.А. Клиническая электроэнцефалография (обзор литературы и перспективы использования метода). – М.: Мэйби, 1991. – 118 с. [Zhirmunskaja EA. Klinicheskaya ehlektroehntsefalografiya (obzor literatury i perspektivy ispol’zovaniya metoda). Moscow: Mehibi; 1991. 118 p. (In Russ.)]
- Мелашенко Т.В., Фомина М.Ю. Изменения электробиологической активности головного мозга у доношенных новорожденных с гипоксически-ишемической энцефалопатией // Педиатр. – 2020. – Т. 11. – № 2. – C. 73–84. [Melashenko TV, Fomina MYu. Changes in the electrobiological activity of the brain in full-term newborns with hypoxic-ischemic encephalopathy. Pediatrician (St. Petersburg). 2020;11(2):73-84. (In Russ.)] https://doi.org/10.17816/PED11273-84.
- Мелашенко Т.В., Фомина М.Ю., Павлова О.И. Особенности межиктальной электрической активности головного мозга у доношенных новорожденных с судорожным синдромом при церебральной ишемии // Нейрохирургия и неврология детского возраста. – 2018. – № 3(57). – С 8–14. [Melashenko TV, Fomina MYu, Pavlova OI. Features of interictal brain activity in term infants with convulsive syndrome in cerebral ischemia. Neurosurgery and neurology of childhood. 2018;3(57):8-14. (In Russ.)]
- Понятишин А.Е., Пальчик А.Б. Электроэнцефалография в неонатальной неврологии. – Санкт-Петербург: Сотис, 2010. – 172 c. [Ponjatishin AE, Pal’chik AB. Ehlektroehntsefalografiya v neonatal’noi nevrologii. Saint Petersburg: Sotis; 2010. 172 p. (In Russ).]
- Фомина М.Ю., Мелашенко Т.В., Павлова О.И. Неонатальные судороги у доношенных новорожденных: клинико-электрофизиологические особенности // Педиатр. – 2018. – Т. 9. – № 5. – C. 13–20. [Fomina MY, MeLashenko TV, Pavlova OI. Neonatal seizures in term infants: clinical and electrophysiological features. Pediatrician (St. Petersburg). 2018;9(5):13-20 (In Russ.)] https://doi.org/10.17816/PED9513-20.
- Bauer G, Trinka E, Koplan PW. EEG patterns in hypoxic encephalopathies (post-cardiac arrest syndrome): fluctuations, transitions, and reactions. J Clin Neurophysiol. 2013;30(5):477-489. https://doi.org/10.1097/wnp.0b013e3182a73e47.
- Hagberg H, Edwards AD, Groenendaal F. Perinatal brain damage: The term infant. Neurobiol Dis. 2016;92(Pt A):102-112. https://doi.org/10.1016/j.nbd.2015.09.011.
- Simon RP, Aminoff MJ. Electrographic status epilepticus in fatal anoxic coma. Ann Neurol. 1986;20(3):351-355. https://doi.org/10.1002/ana.410200313.
- Westmoreland B, Klass DW, Sharbrough FW, Reagan TJ. Alpha-coma: electroencephalographic, clinical, pathologic and etiological correlations. Arch Neurol. 1975;32(11):713-718. https://doi.org/10.1001/archneur.1975.00490530035001.
- Wilson JA, Nordal HJ. EEG ved coma. Tidsskr Nor Legeforen. 2013;133(1):53-57. (In Norwegian.) https://doi.org/10.4045/tidsskr.11.1432.
- Wusthoff CJ, Sullivan S, Glass HC, et al. Interrater Agreement in the Interpretation of Neonatal Electroencephalography in Hypoxic Ischemic Encephalopathy. Epilepsia. 2017;58(3):429-435. https://doi.org/10.1111/epi.13661.
- Volpe J, Inder T, Darras B, et al. Volpe’s Neurology of the Newborn. 6th Edn. Elеsivier; 2017.
- Young GB, McLachlan RS, Kreeft JH, DeMelo JD. An electroencephalographic classification system for coma. Can J Neurol Sci. 1997;24(4):320-325. https://doi.org/10.1017/S0317167100032996.
- Young G.B. The EEG in Coma. J of Clin Neurophysiol. 2000;17(5):473-485. https://doi.org/10.1097/ 00004691-200009000-00006.