Phenobarbital reduces EEG amplitude and propagation of neonatal seizures but does not alter performance of automated seizure detection. Issue 10 (October 2016)

• Record Type: Journal Article
• Authors: Mathieson, Sean R.; Livingstone, Vicki; Low, Evonne; Pressler, Ronit; Rennie, Janet M.; Boylan, Geraldine B.
• Is Part Of: Clinical neurophysiology. Volume 127:Issue 10(2016:Oct.)
• Page Start: 3343
• Page End: 3350
• Publication Date: 2016-10
• Subjects: Electroclinical uncoupling -- Neonatal seizures -- Automated seizure detection; Neurophysiology -- Periodicals; Electroencephalography -- Periodicals; Electromyography -- Periodicals; Neurology -- Periodicals; 612.8
• DOI: 10.1016/j.clinph.2016.07.007
• Languages: English
• ISSNs: 1388-2457

Abstract

Highlights: Phenobarbital reduces both amplitude and propagation of neonatal seizures. These changes may help to explain electroclinical uncoupling. The performance of our seizure detection algorithm was unaffected. Abstract: Objective: Phenobarbital increases electroclinical uncoupling and our preliminary observations suggest it may also affect electrographic seizure morphology. This may alter the performance of a novel seizure detection algorithm (SDA) developed by our group. The objectives of this study were to compare the morphology of seizures before and after phenobarbital administration in neonates and to determine the effect of any changes on automated seizure detection rates. Methods: The EEGs of 18 term neonates with seizures both pre- and post-phenobarbital (524 seizures) administration were studied. Ten features of seizures were manually quantified and summary measures for each neonate were statistically compared between pre- and post-phenobarbital seizures. SDA seizure detection rates were also compared. Results: Post-phenobarbital seizures showed significantly lower amplitude ( p < 0.001) and involved fewer EEG channels at the peak of seizure ( p < 0.05). No other features or SDA detection rates showed a statistical difference. Conclusion: These findings show that phenobarbital reduces both the amplitude and propagation of seizures which may help to explain electroclinical uncoupling of seizures. The seizure detection rate of the algorithm was unaffected by these changes. Significance: The results suggest that users should not need to adjust the SDA sensitivity threshold after phenobarbital administration.