Electroencephalogram of the full-term newborn. Normal features and hypoxic-ischemic encephalopathy

The objective of this work is to specify, by reference to the normal newborn, the current contribution of the electroencephalogram in the hypoxic-ischemic encephalopathy of the full-term newborn. Both digitized traditional EEG and cerebral function monitoring (CFM) will be considered. We first describe the main features of normal and pathological EEGs. A good knowledge of the organization of the sleep-wakefulness cycles, in relationship with the EEG, is essential. Very early recordings (before 6 hours of life) are needed to put the indications of neuroprotective treatments (hypothermia). Between the normal or near-normal tracings, which are associated with a good prognosis, and the very pathological tracings (inactive, paroxysmal), which are associated with a poor vital or functional prognosis, the interpretation of "intermediate" tracings mainly represented by other types of discontinuous tracings must take into account characteristics of bursts and discontinuities, postnatal age, the evolution of successive tracings, and pharmacological treatments. A flowchart is used to illustrate our strategy of EEG watching over a full-term newborn after an acute fetal distress. (C) 2010 Elsevier Masson SAS. All rights reserved.