EEG RESPONSE TO ANTICONVULSANT IN NEONATAL CLINICAL SEIZURES

The purpose of this study is to better define seizure activity and to make anticonvulsant therapy optimal. During a period of 4.5 years, 57 infants with clinical evident seizures underwent continuous EEG monitoring (C.F.M., Device Instrument, Ltd, London). C.F.M. tracing showed seizure activity in 31 (54.4 %), and none in 26 (45.6 %). 20 of the 31 subjects with C.F.M. documented activity and 20 of those 26 without, had already begun anticonvulsant therapy at the beginning of C.F.M. monitoring. The efficacy of the anti-convulsant drugs was evaluated in 31 infants having both clinical and C.F.M. documented seizure activity. 20 infants began C.F.M. monitoring after, and 11 before beginning anticonvulsant therapy. Phenobarbital, the drug of first choise, was efficacious in 4 out of the 27 cases, but useless in 16 of the 27. The best responce was obteined with lidocaine, efficacious in 14 out of 20 patients treated. In conclusion, 45.6 % of the clinical seizures have no C.F.M. equivalent. In the large pan of the cases, commonly used anti-convulsant drugs did not eliminate the seizure activity found on C.F.M. The persistent electrical seizures are considered to be damaging. Continuous neurophysiologies! monitoring is a very usefull means for evaluating the efficacy of anticonvulsant therapy.