Neuropediatrics 2004; 35(6): 329-335
DOI: 10.1055/s-2004-830367
Original Article

Georg Thieme Verlag KG Stuttgart · New York

Neonatal Seizure Monitoring Using Non-Linear EEG Analysis

L. S. Smit1 , 4 , R. J. Vermeulen2 , W. P. F. Fetter3 , R. L. M. Strijers1 , C. J. Stam1
  • 1Department of Clinical Neurophysiology/MEG Centre, VU University Medical Centre, Amsterdam, The Netherlands
  • 2Department of Child Neurology, VU University Medical Centre, Amsterdam, The Netherlands
  • 3Department of Neonatology, VU University Medical Centre, Amsterdam, The Netherlands
  • 4Present Address: Department of Pediatric Neurology and Department of Neonatology, Erasmus Medical Centre/Sophia Children's Hospital, Rotterdam, The Netherlands
Further Information

Publication History

Received: April 22, 2004

Accepted after Revision: September 10, 2004

Publication Date:
15 November 2004 (eFirst)


Birth asphyxia is a major concern in neonatal care. Epileptic seizures are associated with subsequent neurodevelopmental deficits. Eighty-five percent of these seizures remain subclinical and therefore an on-line monitoring device is needed. In an earlier study we showed that the synchronization likelihood was able to distinguish between neonatal EEG epochs with and without epileptic seizures. In this study we investigated whether the synchronization likelihood can be used in complete EEGs, without artifact removal. Twenty complete EEGs from 20 neonatal patients were studied. The synchronization likelihood was calculated and correlated with the visual scoring done by 3 experts. In addition, we determined the influence of seizure length on the likelihood of detection. Using the raw unfiltered EEG data we found a sensitivity of 65.9 % and a specificity of 89.8 % for the detection of seizure activity in each epoch. In addition, the seizure detection rate was 100 % when the seizures lasted for 100 seconds or more. The synchronization likelihood seems to be a useful tool in the automatic monitoring of epileptic seizures in infants on the neonatal ward. Due to the retrospective nature of our study, the consequences for clinical intervention cannot yet be determined and prospective studies are needed. Therefore, we will conduct a prospective study on the neonatal intensive care unit with a recently developed on-line version of the synchronization likelihood analysis.


Dr. R. J. Vermeulen

Department of Pediatric Neurology
Vrije Universiteit Medisch Centrum

De Boelelaan 1117

Postbox 7057

1007 MB Amsterdam

The Netherlands