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Epilepsy Research Center, the Section of Neurophysiology, Department of Neurology, and the Section of Pediatric Neurology, Department of Pediatrics, Baylor College of Medicine; The Methodist Hospital; and Texas Children's Hospital, Houston, TX.
To characterize and classify neonatal seizures, we studied 349 neonates, using a portable, cribside EEG/ polygraphic/video monitoring system. We recorded 415 clinical seizures in 71 infants; 11 other infants had electrical seizure activity without clinical accompaniments. Each seizure was analyzed in terms of its clinical character and its relationship to the presence of EEG seizure activity. Focal clonic seizures, some forms of myoclonic seizures, and focal tonic seizures were consistently associated with electrical seizure activity. Most "subtle" seizures, all generalized tonic seizures, and some forms of myoclonic seizures were either not associated with EEG seizure activity or had an inconsistent relationship with such activity. Seizures that were consistently and coherently related to focal EEG seizure activity had a high correlation with focal brain lesions and a favorable short-term outcome. Seizures with no relationship or an inconsistent relationship to EEG seizure activity were correlated with diffuse processes such as hypoxic-ischemic encephalopathy and a poor short-term outcome. The clinical and background EEG features of infants whose seizures were not accompanied by EEG seizure activity suggest that these seizures may not be epileptic in character.
Address correspondence and reprint requests to Dr. Mizrahi, Department of Neurology, Section of Neurophysiology, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030.
Supported by grant NS11535 and by Teacher-Investigator Development Award NS00810 (to E. M. M.) from the National Institute of Neurological and Communicative Disorders and Stroke, National Institutes of Health.
Received January 14, 1987. Accepted for publication in final form February 17, 1987.
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