Amplitude integrated electroencephalography in the full-term newborn

Approximately 10 to 15 years ago, few centers in the world used continuous electroencephalography (EEG) monitoring in full-term newborns admitted with neonatal encephalopathy (NE) or seizures. The absence of neurologic monitoring contrasted greatly with monitoring of respiratory rate, heart rate, ECG, oxygen saturation, and blood pressure, which were all well integrated into the routine care of any newborn infant admitted to a neonatal intensive care unit (NICU). When clinical seizures were suspected, a standard EEG would be performed and, if seizures were detected, treatment initiated with phenobarbitone and phenytoin, the most common antiepileptic drugs. The neurophysiologist would then assess the background pattern and the results would be considered in giving the prognosis. A few studies using video-EEG recordings have shown that the commonly used antiepileptic drugs are only effective in approximately half of the infants [1]. Furthermore, experts have increasingly recognized that subclinical seizures are very common, especially after antiepileptic drugs are administered [2,3].