Neonatal seizures

In contrast to seizures in older children, EEG monitoring is essential to accurately detect ongoing seizures in neonates given the high frequency of electrographic- only seizures and their variable clinical expression. EEG monitoring needs to be available 24 hours a day in neonatal intensive care units for optimal surveillance, which is challenging. Many units in Europe therefore use amplitude integrated EEG (aEEG), which is less accurate in detecting seizures. Accurate seizure detection is essential for appropriate and prompt treatment and for randomised trials of new treatments.

Our WG began work on a protocol for neonatal EEG monitoring and reviewed all the published protocols at the same time as the Italian Neonatal Seizure Collaborative Network (INNESCO) worked, with contribution from EpiCARE members, on a comprehensive protocol (Dilena et al 2021), which was adopted by EpiCARE. The ILAE have recently published guidelines and consensus-based recommendations for the treatment of seizures in the neonate, which have been developed with members of the EpiCARE neonatal WG. The group also:

– Developed a free neonatal EEG eLearning module to help centres across Europe get EEG monitoring up and running, to recognise the common neonatal seizures types and to distinguish them from common artefacts encountered in the NICU.

– Working on the development of a Neonatal Seizures Registry with a multicentre open cohort design that includes acute symptomatic seizures and neonatal-onset epilepsies, the results of diagnostic biochemical, MRI and genetic tests, together with the aetiologies. In the next phase, we will assess if this real-world data can be used to promote collaborative research across Europe.

We will also assess neonatal EEG and seizure AI algorithms and develop guidelines for their use in neonatal EEG monitoring but also in clinical trials of new treatments.