Neonatal Care Academy

Delay in Treatment of Neonatal Seizures

Literature on timing of AED treatment is scarce, however there is increasing support to suggest that earlier intervention with subsequent reduced seizure burden reduces MRI injury and is associated with a better outcome.  Bearing in mind that rapidly controlling seizures makes them easier to treat and could protect the brain from further damage, there is definitely still room for improvement with regard to time to treatment.

In this study the authors reviewed the timing of AED treatment in a level III neonatal intensive care unit (NICU) with long-standing expertise in using aEEG and a policy of active seizure treatment.  Second, factors associated with recognition of seizures and delay of treatment by the clinician were determined.


Of the first seizures, 50.5% were detected by the Seizure Detection Algorithm (SDA) and 50.9% were associated with clinical signs. A significantly higher percentage of detection for seizures treated within 1 h demonstrates how using an SDA improves the time to treatment. treatment. Furthermore, seizure detection together with clinical signs account for better recognition of seizures by the clinician. This confirms the value of SDA systems as demonstrated in earlier studies and calls for further development of these detection algorithms, increasing detection rates and decreasing false positive detection


In this population only 32.1% of the first seizures confirmed on aEEG were treated within 1 h. Even though this is a higher treatment rate within 1 h than has been reported previously, there is room for improvement. Clinical signs and detection by the SDA play a major role in prompt treatment of seizures.

In Conclusion, monitoring with aEEG is useful for treatment of seizures 24/7, especially at sites where cEEG cannot be assessed continuously, resulting in delayed diagnosis and treatment.


Read the full text of this article at karger.com

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September 16, 2020
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