Can continuous brain monitoring help me care for infants with seizures?
Due to their subtle presentation, neonatal seizures are a common and frustrating diagnosis to make in the NICU. When caring for an infant with suspected seizures, real-time electrographic data can be extremely useful if used in combination with a detailed patient history, a thorough physical examination, and concurrent observation of physiologic parameters and behavioral signs. Subclinical seizures, or those seizures that do not exhibit clinical signs, are very common in neonates and have been reported to occur in as many as 50% of infants who have been treated with anti-epileptic medications (Painter et al, 1999). This phenomenon is commonly termed electro-clinical dissociation. The use of continuous bedside brain monitoring before, during, and after the administration of anti-epileptic medications can aid clinicians in evaluating the effectiveness of treating the electrical component of the seizure. Decisions to initiate and perhaps even escalate a medication regimen could potentiall
