P02-F Early EEG characteristics in hypoxic-ischemic encephalopathy and outcome at 2 years

EEG is an important tool for early cerebral evaluation in neonatal hypoxo-ischemic encephalopathy (HIE). The aim of our study was to precise the EEG prognosis value before starting hypothermia and during 72 h hypothermia in neurodevelopment evaluation with at least 2 years clinical follow-up. We analyzed 98 newborns admitted for suspicion of HIE. First EEG was done before 6 h of life, it was surveyed continuously and analyzed twice a day during 72 H hypothermia and in 12 h following rewarming. EEG recordings were characterized according to the French classification. The neurologic outcome was assessed at 24 months. Eighty-four infants completed neurodevelopmental follow-up. 18 of newborns died during the neonatal period. Among the survivors, 64%, 21% and 15% had respectively normal, moderate and severe outcomes. The first EEG before hypothermia do not correlated with the neurodevelopmental outcome. On the other hand, The EEG characteristics between 36 and 60 h of life, correlated strongly with the outcome. Normal or mildly abnormal EEG (minor abnormalities or discontinuous tracing type A) after the first 48 h had 95% positive predictive value EEG for normal or moderate impairment at 2 years (negative predictive value 77%, specificity 91%). Severe EEG abnormalities (discontinuous tracing type B, paroxysmal or inactive tracings) within the first 48 h had respectively 96% and 76% negative and positive value for poor outcomes (severe outcome or death) (sensitivity 91% and specificity 89%).