The Children’s Hospital of Philadelphia recently announced that a team of researchers has found an easy and effective method of monitoring seizures in newborns. The method can help to catch more cases of seizures than the current, typical methods that are being used in many facilities today. This has the potential to help improve the overall quality of care for these infants, particularly in hospitals that may not have the needed resources to detect the seizures. The team had their findings published in the Journal of Clinical Neurophysiology.
The Monitoring Methods Proved Successful
Mark P. Fitzgerald, MD, Ph.D., is a pediatric neurologist working in the Division of Neurology at Children’s Hospital of Philadelphia and is the lead author of the study. He said that the “study allowed us to test a framework for expanding remote continuous monitoring of at-risk neonates, beginning at two regional affiliate hospital NICUs within our network.”
They found that their method would allow for monitoring that was feasible from a technical standpoint and that it would allow the infants to receive local care. The research also shows that it was possible to help improve the clinical care that the babies were receiving.
It’s unfortunate, but many children suffer from neonatal seizures. The seizures can occur in four out of every 1,000 live births. The seizures could be related to a range of underlying conditions. There could be a structural injury to the brain, ischemic stroke, or intracranial hemorrhage that causes seizures, for example. Through the use of continuous electroencephalogram (cEEG) monitoring, it becomes possible to identify seizures. The use of this type of monitoring is essential because, in 80% of the seizures, there are not any symptoms that can be identified.
Even when a clinician is highly skilled, they need to utilize cEEG monitoring to see when the seizures occur and to help them provide an accurate diagnosis for the newborn. This is essential to ensure that the infants are receiving a proper dosage of antiseizure medication.
The Barriers to cEEG Could Be Broken
The American Clinical Neurophysiology Society, as well as the World Health Organization, know that continuous EEG monitoring is the best course of action to properly identify seizures. However, there are often problems using this in neonatal intensive care units. Some of the biggest obstacles are not having the right equipment available and not have personnel who can monitor the cEEG. Some facilities might have amplitude-integrated EEGs that they use for monitoring. However, this is not an ideal replacement since it is not as sensitive and capable of detecting seizures as continuous EEG monitoring is.
The researchers were able to develop a framework that would allow them to use the cEEG technology remotely. When using the framework, a hospital would identify a newborn that needs to have continuous EEG monitoring. They might believe that the infant needs monitoring because of unexplained encephalopathy, therapeutic hypothermia, or other concerns they might have regarding seizures with the infant.
Once this occurs, the technician at the hospital can place the EEG leads onto the infant to gather clinical data and then notify the technician at the remote hospital that can then study the results.
The team involved with the study performed this method of monitoring with 76 newborns between June 2017 and September 2019. They were able to locate seizures in about 25% of the records, which allowed them to talk with the newborns’ doctors to ensure they were getting proper treatment.
The pilot program proved successful, and it is hoped that more hospitals that can’t provide monitoring on their own can start to utilize this method. It could make a huge difference in the outcome for many children.