Association Between Electroencephalographic Findings and Neurologic Status in Infants With Congenital Heart Defects
Abstract
Neurologic status is of concern in infants with congenital heart defects undergoing open heart surgery. The association between perioperative electroencephalography (EEG) with acute neurologic status and subsequent outcome was examined in a cohort of 60 infants. Preoperative EEG and neurologic examinations were performed within 1 to 2 days prior to surgery (n = 27) and postoperatively (n = 47). Prior to surgery, 15 of 27 infants had normal EEG, whereas 5 had epileptiform activity and 9 had disturbances in background activity that were primarily moderate (8/9) and diffuse (7/9). Postoperatively, only 17 of 47 infants had normal recordings. Newborns (<1 month) were more likely (P < .001) to demonstrate EEG abnormalities than infants. Epileptiform activity was documented in 15, whereas 28 had background abnormalities that were moderate-severe (22/28) and diffuse (20/28) in most. Epileptiform activity prior to surgery was always associated with an abnormal neurologic examination, and this association persisted postoperatively (86%). Moderate to severe background abnormalities in the postoperative EEG was also strongly associated with acute neurologic abnormalities (93%). Severe background abnormalities (n = 5) were 100% predictive of death or severe disability. Long-term follow-up revealed that all children with normal postoperative EEGs had positive neurologic outcomes (P = .04); however, there were many false positives. Perioperative EEG abnormalities increased the likelihood for acute neurologic findings, whereas normal recordings following surgery were reassuring with regard to a favorable outcome. (J Child Neurol 2001;16:471-476).
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A high prevalence of anatomic and functional neurologic abnormalities has been documented before surgery in newborns with congenital heart disease, and such abnormalities are associated with childhood developmental status.
“Reports from a number of investigators have documented a high prevalence of anatomic and functional neurologic abnormalities prior to surgery in newborns with CHD [9-17], and an association of such abnormalities with childhood developmental status [11,13,18,19].”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [11]
Adverse neurodevelopmental outcomes in children with complex congenital heart disease are due not only to perioperative insult but also to inborn factors.
“However, there is increasing evidence that adverse neurodevelopmental outcomes in children with complex CHD are due not only perioperative insult, but to inborn factors as well.”
From Brain Volume and Metabolism in Fetuses With Congenital Heart Disease: Evaluation With Quantitative Magnetic Resonance Imaging and Spectroscopy (2010) · cites this paper as [11]
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- Authors
- Limperopoulos, C., Majnemer, A., Rosenblatt, B., Shevell, M. I., Rohlicek, C., Tchervenkov, C., & Gottesman, R.
- Affiliations
- Montreal Children's Hospital (CA)
- Venue
- Journal of Child Neurology
- Publisher
- SAGE Publications
- Published
- 2001-07
- Volume
- 16
- Issue
- 7
- Pages
- 471-476
- ISSN
- 0883-0738 (ISSN-L)
- 1708-8283
- OpenAlex
- W2051221006
- Cited by
- 48
- References
- 41
- Citations by year
- 2024: 2 · 2023: 6 · 2022: 2 · 2021: 5 · 2020: 1 · 2019: 1 · 2017: 2 · 2016: 2 · 2015: 2 · 2013: 3
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Child Neurology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Congenital Heart Disease Studies
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Neonatal and fetal brain pathology
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiovascular Conditions and Treatments
- Keywords
- congenital heart disease, infants, neurological outcome, epileptiform activity, EEG background abnormalities, cardiac surgery, neonates
- MeSH terms
- Electroencephalography, Epilepsy, Female, Heart Defects, Congenital, Humans, Infant, Newborn, Male, Predictive Value of Tests, Severity of Illness Index, Cardiovascular Surgical Procedures, Cohort Studies, Children with Disabilities, Disabled Children
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