{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T12:15:04Z","timestamp":1785500104431,"version":"3.56.0"},"reference-count":28,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,11,1]]},"abstract":"<jats:sec>\n                  <jats:title>BACKGROUND:<\/jats:title>\n                  <jats:p>The impact of treating electrographic seizures in hypoxic ischemic encephalopathy (HIE) is unknown.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Neonates \u226536 weeks with moderate or severe HIE were randomly assigned to either treatment of electrographic seizures alone (ESG) or treatment of clinical seizures (CSG). Conventional EEG video was monitored in both groups for up to 96 hours. Cumulative electrographic seizure burden (SB) was calculated in seconds and converted to log units for analysis. MRI scans were scored for severity of brain injury. Infants underwent neurodevelopmental evaluation at 18 to 24 months. Statistical analyses were performed by using SAS 9.3 version (SAS Institute, Inc, Cary, NC).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>Thirty-five of 69 neonates (51%) who were randomly assigned and included in the study developed seizures (15 in ESG and 20 in CSG). Excluding infants with status epilepticus, median SB (interquartile range) in seconds in ESG (n = 10) was lower than in CSG (n = 16) (449 [113\u20132070] vs 2226 [760\u20137654]; P = .02). ESG had fewer seizures with shorter time to treatment (P = .04). Twenty-four of 30 (80%) surviving infants with seizures underwent neurodevelopmental evaluation at 18 to 24 months. Increasing SB in the combined cohort was significantly associated with higher brain injury scores (P &amp;lt; .03) and lower performance scores across all 3 domains on BSID III (P = .03).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>In neonates with HIE, EEG monitoring and treatment of electrographic seizures results in significant reduction in SB. SB is associated with more severe brain injury and significantly lower performance scores across all domains on BSID III.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2014-3777","type":"journal-article","created":{"date-parts":[[2015,10,20]],"date-time":"2015-10-20T12:06:16Z","timestamp":1445342776000},"page":"e1302-e1309","source":"Crossref","is-referenced-by-count":156,"title":["Treating EEG Seizures in Hypoxic Ischemic Encephalopathy: A Randomized Controlled Trial"],"prefix":"10.1542","volume":"136","author":[{"given":"Preethi","family":"Srinivasakumar","sequence":"first","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Zempel","sequence":"additional","affiliation":[{"name":"Neurology, and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamik","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Wallendorf","sequence":"additional","affiliation":[{"name":"Biostatistics, Washington University in St Louis, St Louis Missouri;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rakesh","family":"Rao","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barbara","family":"Smith","sequence":"additional","affiliation":[{"name":"Clinical Neurophysiology Laboratory, St Louis Children\u2019s Hospital, St Louis, Missouri; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Terrie","family":"Inder","sequence":"additional","affiliation":[{"name":"Pediatric Newborn Medicine, Brigham and Women\u2019s Hospital, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amit M.","family":"Mathur","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics,"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2015,11,1]]},"reference":[{"issue":"4","key":"2021120906132977900_B1","doi-asserted-by":"crossref","first-page":"1270","DOI":"10.1542\/peds.2005-1178","article-title":"The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants.","volume":"117","author":"Tekgul","year":"2006","journal-title":"Pediatrics"},{"key":"2021120906132977900_B2","volume-title":"Neurology of the Newborn","author":"Volpe","year":"2008","edition":"5th ed."},{"issue":"3","key":"2021120906132977900_B3","doi-asserted-by":"crossref","first-page":"F165","DOI":"10.1136\/fn.86.3.F165","article-title":"Phenobarbitone, neonatal seizures, and video-EEG.","volume":"86","author":"Boylan","year":"2002","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021120906132977900_B4","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1212\/WNL.55.4.506","article-title":"Electrographic seizures in neonates correlate with poor neurodevelopmental outcome.","volume":"55","author":"McBride","year":"2000","journal-title":"Neurology"},{"issue":"4","key":"2021120906132977900_B5","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/S0887-8994(02)00621-5","article-title":"Uncoupling of EEG-clinical neonatal seizures after antiepileptic drug use.","volume":"28","author":"Scher","year":"2003","journal-title":"Pediatr Neurol"},{"issue":"3","key":"2021120906132977900_B6","doi-asserted-by":"crossref","first-page":"F187","DOI":"10.1136\/adc.2005.086314","article-title":"Defining the gap between electrographic seizure burden, clinical expression and staff recognition of neonatal seizures.","volume":"93","author":"Murray","year":"2008","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"6","key":"2021120906132977900_B7","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1016\/j.jpeds.2009.01.002","article-title":"A pilot study of continuous limited-channel aEEG in term infants with encephalopathy.","volume":"154","author":"Lawrence","year":"2009","journal-title":"J Pediatr"},{"issue":"5","key":"2021120906132977900_B8","doi-asserted-by":"crossref","first-page":"776","DOI":"10.1212\/01.WNL.0000157320.78071.6D","article-title":"Neonatal seizures: after all these years we still love what doesn\u2019t work.","volume":"64","author":"Sankar","year":"2005","journal-title":"Neurology"},{"issue":"2","key":"2021120906132977900_B9","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/j.pediatrneurol.2007.04.003","article-title":"Neonatal seizures: multicenter variability in current treatment practices.","volume":"37","author":"Bartha","year":"2007","journal-title":"Pediatr Neurol"},{"key":"2021120906132977900_B10","first-page":"103","article-title":"Antiepileptic drugs and apoptosis in the developing brain.","volume-title":"Ann N Y Acad Sci","author":"Bittigau","year":"2003"},{"issue":"2","key":"2021120906132977900_B11","doi-asserted-by":"crossref","first-page":"F75","DOI":"10.1136\/fn.86.2.F75","article-title":"The clinical conundrum of neonatal seizures.","volume":"86","author":"Levene","year":"2002","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021120906132977900_B12","doi-asserted-by":"crossref","first-page":"542","DOI":"10.1212\/WNL.58.4.542","article-title":"Seizure-associated brain injury in term newborns with perinatal asphyxia.","volume":"58","author":"Miller","year":"2002","journal-title":"Neurology"},{"issue":"3","key":"2021120906132977900_B13","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1111\/dmcn.12629","article-title":"The aetiology of neonatal seizures and the diagnostic contribution of neonatal cerebral magnetic resonance imaging.","volume":"57","author":"Weeke","year":"2015","journal-title":"Dev Med Child Neurol"},{"issue":"2","key":"2021120906132977900_B14","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2009-0136","article-title":"Effect of treatment of subclinical neonatal seizures detected with aEEG: randomized, controlled trial.","volume":"125","author":"van Rooij","year":"2010","journal-title":"Pediatrics"},{"issue":"3","key":"2021120906132977900_B15","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.jpeds.2009.03.040","article-title":"Clinical neonatal seizures are independently associated with outcome in infants at risk for hypoxic-ischemic brain injury.","volume":"155","author":"Glass","year":"2009","journal-title":"J Pediatr"},{"issue":"2","key":"2021120906132977900_B16","doi-asserted-by":"crossref","DOI":"10.1542\/peds.2006-3007","article-title":"Neurodevelopmental outcome in term infants with status epilepticus detected with amplitude-integrated electroencephalography.","volume":"120","author":"van Rooij","year":"2007","journal-title":"Pediatrics"},{"issue":"6","key":"2021120906132977900_B17","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1097\/WNP.0b013e31823e96d7","article-title":"The American Clinical Neurophysiology Society\u2019s guideline on continuous electroencephalography monitoring in neonates.","volume":"28","author":"Shellhaas","year":"2011","journal-title":"J Clin Neurophysiol"},{"issue":"1","key":"2021120906132977900_B18","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1111\/j.1528-1157.1991.tb05614.x","article-title":"Postnatal epilepsy after EEG-confirmed neonatal seizures.","volume":"32","author":"Clancy","year":"1991","journal-title":"Epilepsia"},{"issue":"6","key":"2021120906132977900_B19","doi-asserted-by":"crossref","first-page":"707","DOI":"10.1067\/mpd.2002.124773","article-title":"Prediction of outcome based on clinical seizure type in newborn infants.","volume":"140","author":"Brunquell","year":"2002","journal-title":"J Pediatr"},{"issue":"2","key":"2021120906132977900_B20","doi-asserted-by":"crossref","first-page":"F97","DOI":"10.1136\/fn.72.2.F97","article-title":"Low risk of seizure recurrence after early withdrawal of antiepileptic treatment in the neonatal period.","volume":"72","author":"Hellstr\u00f6m-Westas","year":"1995","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021120906132977900_B21","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.pediatrneurol.2004.11.005","article-title":"Postneonatal epilepsy following amplitude-integrated EEG-detected neonatal seizures.","volume":"32","author":"Toet","year":"2005","journal-title":"Pediatr Neurol"},{"issue":"15","key":"2021120906132977900_B22","doi-asserted-by":"crossref","first-page":"1574","DOI":"10.1056\/NEJMcps050929","article-title":"Whole-body hypothermia for neonates with hypoxic-ischemic encephalopathy.","volume":"353","author":"Shankaran","year":"2005","journal-title":"N Engl J Med"},{"issue":"18","key":"2021120906132977900_B23","doi-asserted-by":"crossref","first-page":"1420","DOI":"10.1212\/WNL.0b013e318253d589","article-title":"Impact of therapeutic hypothermia on MRI diffusion changes in neonatal encephalopathy.","volume":"78","author":"Bednarek","year":"2012","journal-title":"Neurology"},{"key":"2021120906132977900_B24","volume-title":"Bayley III Scales of Infant and Toddler Development","author":"Bayley","year":"2006","edition":"3rd ed."},{"issue":"3","key":"2021120906132977900_B25","doi-asserted-by":"crossref","first-page":"F219","DOI":"10.1136\/archdischild-2013-305206","article-title":"Electrographic seizures are associated with brain injury in newborns undergoing therapeutic hypothermia.","volume":"99","author":"Shah","year":"2014","journal-title":"Arch Dis Child Fetal Neonatal Ed"},{"issue":"4","key":"2021120906132977900_B26","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1203\/00006450-200110000-00005","article-title":"Prolonged seizures exacerbate perinatal hypoxic-ischemic brain damage.","volume":"50","author":"Wirrell","year":"2001","journal-title":"Pediatr Res"},{"issue":"10","key":"2021120906132977900_B27","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1111\/j.1651-2227.1992.tb12109.x","article-title":"Comparison between tape-recorded and amplitude-integrated EEG monitoring in sick newborn infants.","volume":"81","author":"Hellstr\u00f6m-Westas","year":"1992","journal-title":"Acta Paediatr"},{"issue":"5","key":"2021120906132977900_B28","doi-asserted-by":"crossref","first-page":"772","DOI":"10.1542\/peds.109.5.772","article-title":"Comparison between simultaneously recorded amplitude integrated electroencephalogram (cerebral function monitor) and standard electroencephalogram in neonates.","volume":"109","author":"Toet","year":"2002","journal-title":"Pediatrics"}],"container-title":["Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/5\/e1302\/1094770\/peds_2014-3777.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/publications.aap.org\/pediatrics\/article-pdf\/136\/5\/e1302\/1094770\/peds_2014-3777.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,10]],"date-time":"2021-12-10T00:32:38Z","timestamp":1639096358000},"score":1,"resource":{"primary":{"URL":"https:\/\/publications.aap.org\/pediatrics\/article\/136\/5\/e1302\/33845\/Treating-EEG-Seizures-in-Hypoxic-Ischemic"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,11,1]]},"references-count":28,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2015,11,1]]},"published-print":{"date-parts":[[2015,11,1]]}},"URL":"https:\/\/doi.org\/10.1542\/peds.2014-3777","relation":{},"ISSN":["0031-4005","1098-4275"],"issn-type":[{"value":"0031-4005","type":"print"},{"value":"1098-4275","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,11,1]]}}}