EEG findings and outcomes of continuous video-EEG monitoring started prior to initiation of seizure treatment in the perinatal stroke

Abstract Background To analyze the findings in the background EEG activity of infants who suffered perinatal stroke. Methods Eleven neonates born 2009–2014 diagnosed of ischemic stroke by MRI (three of them with multistroke) underwent continuous video-EEG monitoring. Visual and spectral (power spectrum and coherence) analyses of the background EEG was performed in three moments: 1) Onset of EEG recording (prior to initiate seizure treatment), 2) Post-ictal epoch (1–2 h after the last seizure), and 3) one–two days after seizure control. All children aged 2–6 years underwent neurodevelopmental assessment. Results Discontinuity, asymmetry, asynchrony, transients, and relative power spectrum in δ and θ frequency bands increased significantly ( p p  = 0.002; p  = 0.001, respectively) exclusively in the post-ictal epoch. Seizure burden and time-to-control ranged 5–38 min and 0.5–40 h respectively. Currently, only one child is affected by spastic monoparesis. The intelligence quotients ranged 96–123. Conclusions The background EEG can undergo significant changes in the post-ictal epoch due to the seizure activity triggered by the perinatal stroke. Most of these EEG changes involve all brain activity and not exclusively the ischemic hemisphere. Many of these modifications in the EEG background reverse following the seizure control. Video-EEG monitoring allows accurate/immediate diagnosis and rapid/intensive treatment of the stroke-associated seizures.