Clinical neurophysiology in neonatology

Expert consensus on minimum technical standards for neonatal electroencephalography operation and report writing

Electroencephalography (EEG) monitoring is an important examination method in the management of critically ill neonates, which can be used to evaluate brain function and developmental status, severity of encephalopathy, and seizures and predict the long-term neurodevelopmental outcome of high-risk neonates with brain injury. EEG monitoring for neonates is different from that for adults and children, and its operation and interpretation are easily affected by the number of recording electrodes, electrode montage, and monitoring quality. Therefore, standard operation must be followed to ensure the quality of signal acquisition and correct interpretation, thereby ensuring proper management of critically ill neonates. The Subspecialty Group of Neonatology, Society of Pediatrics, Chinese Medical Association established an expert group composed of professionals in neonatology and brain electrophysiology to perform a literature review, summarize the minimum technical standards for neonatal EEG monitoring, and develop the expert consensus on minimum technical standards for neonatal EEG operation and report writing. This consensus will provide guidance for neonatal EEG operation, including technical parameters of EEG monitoring device, operation procedures of EEG monitoring, and specifications for report writing.

Technical recommendations and interpretation guidelines for electroencephalography for premature and full-term newborns

Electroencephalography (EEG) of neonatal patients is amongst the most valuable diagnostic and prognostic tool. EEG recordings, acquired at the bedside of infants, evaluate brain function and the maturation of premature and extremely premature infants. Strict conditions of acquisition and interpretation must be respected to guarantee the quality of the EEG and ensure its safety for fragile children. This article provides guidance for EEG acquisition including: (1) the required equipment and devices, (2) the modalities of installation and asepsis precautions, and (3) the digital signal acquisition parameters to use during the recording. The fundamental role of a well-trained technician in supervising the EEG recording is emphasized. In parallel to the acquisition recommendations, we present a guideline for EEG interpretation and reporting. The successive steps of EEG interpretation, from reading the EEG to writing the report, are described. The complexity of the EEG signal in neonates makes artefact detection difficult. Thus, we provide an overview of certain characteristic artefacts and detail the methods for eliminating them.