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Neonatal EEG Patterns
The document outlines the development of neonatal EEG patterns, detailing the transition from discontinuous to continuous activity as gestational age increases. Key features include the appearance of beta-delta complexes, temporal theta bursts, and frontal sharp waves, along with the reactivity to stimuli. The EEG maturation is described in terms of synchrony, voltage amplitude, and frequency patterns at various gestational and postnatal ages.
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Neonatal EEG Patterns
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- 3. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 4. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 5. • • • • Activity discontinuous inearly life Long periods of electrical silence Presen in both sleep and awake records Seen till 30th week CA • This pattern is referred to as ‘Trace Discontinua’
- 7. • EEG activitybecomes continuous during waking by 34 weeks CA • EEG activity becomes continuous during NREM by 37 weeks CA • However, semi-periodic, voltage attenuation still seen during NREM sleep, lasting for 1015 seconds • Present upto 5-6 weeks of age
- 11. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 12. • EEG activityasynchronous till 28 weeks CA • Degree of asynchrony decreases with age, mature brain has minimal asynchrony
- 13. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 14. • Beta-delta waveformsare composed of random wave forms • 0.3-1.5 Hz frequency, superimposed on fast frequency • Fast frequency in two frequency bands • 8-12 Hz and 18-22 Hz • Voltage <75 • Also known as spindle delta bursts, ripples of prematurity, etc
- 16. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 17. • Appear by26 weeks CA • 4.5-6 Hz, 20-200 µv • Occur independently for short bursts, <2 sec • Expressed maximally at 30-32 weeks CA, then decline in frequency • Used to determine CA, replaced by alpha rhythm
- 19. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 20. • Bilaterally synchronous •Present from 35 week CA, up to 44 weeks, till 6weeks post term • 50-150 µv • Resemble vertex sharp waves
- 21. Parameter Normal Abnormal Amplitude 50-150 µv > 150µv Duration <100 msec >150 msec Initial Polarity Surface negative Surface positive or negative Phase Mono or diphasic Polyphasic Occurrence Random, bilateral, Sleep Runs, 1Hz, unilateral, awake Following slow wave Absent Present
- 22. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 23. • Response easilyidentifiable by 37 weeks CA • Generalised attenuation or rarely augmentation of voltage to loud sounds seen by 34 th week • If background is high voltage delta, response is attenuation • If background is low voltage theta, response is augmentation
- 24. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
- 25. • Distinction clearby 36th week CA • Till that age, Beta Delta complexes dominate • These change to random, semi arrhythmic activity at 4-8 Hz • Trace alternans seen during 36-38 weeks
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- 27. Road Map forthe Session • • • • • • • Continuity Inter-hemispheric Synchrony Beta-Delta Complexes Temporal Theta Bursts Frontal Sharp Waves Reactivity to Stimulus Differentiation between sleep and awake eeg
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- 34. Roffwarg, Muzio, andDement. Science, 1966 34