Tine Brink Henriksen

Early epileptiform discharges are a marker of moderate asphyxia in near-term fetal sheep

Publikation: KonferencebidragKonferenceabstrakt til konferenceForskningpeer review

  • Ted Carl Andelius
  • Joanne O Davidson, Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, New Zealand
  • Paul Drury, Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, New Zealand
  • Guido Wassink, Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, New Zealand
  • Tine Brink Henriksen
  • Alistair J Gunn, Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, New Zealand
  • Laura Bennet, Department of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand, New Zealand
Introduction: Hypoxic ischemic encephalopathy (HIE) is a major cause of neurological impairment and death at birth. It is essential to start therapeutic hypothermia as early as possible after birth for optimal neurologic outcome. Thus, fast and accurate diagnosis is essential. However, it can be difficult to distinguish mild and moderate HIE in the first few hours after birth. A variety of epileptiform transients have been associated with preterm brain injury but their significance is unclear at term. We therefore compared the early evolution of electroencephalographic (EEG) patterns after exposure to mild or moderate asphyxia.

Material and Methods: Near-term fetal sheep received profound asphyxia induced by umbilical cord occlusion (UCO) for either 10 minutes (mild, n=13) or 15 minutes (moderate, n=11). Eight different EEG patterns were identified; single wave, poly wave, cluster, bursts, epileptiform discharges, brief rhythmic discharge, and 3-6Hz burst and seizures. The presence of each pattern was quantified in 1-minute epochs for the first six hours after UCO.

Results and Discussion: Both groups showed frequent single waves, poly waves and clusters, whereas only a minority showed bursts, 3-6Hz bursts, brief rhythmic discharges or overt seizures. In contrast, epileptiform discharges were significantly more common after moderate than mild UCO, in the first, second and 6th hour after UCO. For example during the second hour there were 847±206.6 sec vs. 139.8±62.5 sec of epileptiform discharges (Mean±SEM), and, strikingly, the increase after moderate UCO was seen as early as 15 min.

Conclusion: This novel EEG pattern has potential to support accurate and early diagnosis of moderate asphyxial injury. Potentially, shorter forms of epileptiform transients may be useful for assessment of mild HIE.
OriginalsprogEngelsk
Udgivelsesår2018
StatusUdgivet - 2018
Begivenhed45th Annual Meeting on Fetal and Neonatal Physiological Society - Maastricht, Holland
Varighed: 24 jun. 201827 jun. 2018
http://www.fnps2018.nl

Konference

Konference45th Annual Meeting on Fetal and Neonatal Physiological Society
LokationMaastricht
LandHolland
Periode24/06/201827/06/2018
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