• Mireille D Bourez-Swart, Linda van Rooij, Cristiano Rizzo, Linda S de Vries, Mona C Toet, Tineke A Gebbink, Anja G J Ezendam, and Alexander C van Huffelen.
• Department of Clinical Neurophysiology, University Medical Center Utrecht/Wilhelmina Children's Hospital, Rudolf Magnus Institute of Neuroscience Utrecht, The Netherlands. mbourez@sein.nl
• Clin Neurophysiol. 2009 Nov 1;120(11):1916-22.

ObjectiveTo compare the seizure pattern detection rate of single-channel and multichannel amplitude-integrated EEG (aEEG), using conventional EEG (cEEG) as a gold standard, in full-term neonates with hypoxic-ischemic encephalopathy. The optimal electrode derivation for seizure detection with single-channel aEEG was also investigated.MethodsTwelve infants with cEEG seizure patterns (10s) were investigated. cEEG signals were transformed into aEEG signals. Seizure patterns and the number of patients identified with 1 seizure patterns were calculated for single- and multichannel aEEG.ResultsOn cEEG, 121 seizure patterns with a mean duration of 58s were identified, 68% of which occurred over the centrotemporal region. The sensitivity of aEEG for the detection of seizure patterns was 30% (C.I.: 0.22-0.38) for single-channel aEEG and 39% (C.I.: 0.31-0.48) for multichannel aEEG. Multichannel aEEG identified all patients with 1 seizure pattern (C.I.: 0.75-1.00), whereas single-channel aEEG (with C4-C3 as the optimal electrode derivation) identified all but one of the patients (C.I.: 0.66-0.99).ConclusionsSeizure pattern detection rate is slightly better with multichannel aEEG compared with single-channel (C4-C3) aEEG. Multichannel aEEG identified correctly all patients with 1 seizure pattern in this small selection of patients.SignificanceSingle-channel aEEG may detect most patients (in a selected group) with severe neonatal seizures patterns; patient identification can be improved using multichannel recordings.

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