PROGNOSTIC VALUE OF EEG IN NEONATAL MENINGITIS - RETROSPECTIVE STUDY OF 29 INFANTS

被引:22
|
作者
CHEQUER, RS
THARP, BR
DREIMANE, D
HAHN, JS
CLANCY, RR
COEN, RW
机构
[1] STANFORD UNIV, MED CTR, DIV PEDIAT NEUROL, STANFORD, CA 94305 USA
[2] CHILDRENS HOSP PHILADELPHIA, DIV PEDIAT NEUROL, PHILADELPHIA, PA USA
[3] UNIV CALIF SAN DIEGO, DIV PEDIAT NEUROL, SAN DIEGO, CA 92103 USA
[4] UNIV CALIF SAN DIEGO, DEPT PEDIAT, DIV NEONATOL, SAN DIEGO, CA 92103 USA
关键词
D O I
10.1016/0887-8994(92)90001-F
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Neonatal meningitis is associated with significant neurologic sequelae. Previous studies from our laboratory and others demonstrated electroencephalography (EEG) to be a useful tool in predicting long-term neurologic outcome in at-risk neonates. We, therefore, retrospectively studied 29 infants with culture-proved neonatal meningitis who died in the neonatal period or survived to follow-up at a mean of 34.4 months. Seventy-five EEGs were obtained during the acute phase of infection; the degree of EEG background abnormality proved to be an accurate predictor of outcome. Infants who had normal or mildly abnormal backgrounds had normal outcomes, whereas those with markedly abnormal EEGs died or manifested severe neurologic sequelae at follow-up. When the EEG was considered with the presence or absence of seizures and the level of consciousness, an accurate prediction of neurologic outcome was obtained in 27 infants (93%). Although the EEG patterns were generally nonspecific, some abnormalities, such as positive rolandic sharp waves, persistent hemispheric or focal voltage attenuation, suggested more specific pathology (i.e., deep white matter necrosis, large-vessel infarction and abscess, respectively). EEG was also valuable for the recognition of subtle and subclinical seizures. Therefore, we conclude that EEG is a valuable tool for predicting the long-term prognoses of infants with neonatal meningitis.
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页码:417 / 422
页数:6
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