Neuropediatrics 2006; 37(5): 265-268
DOI: 10.1055/s-2006-924614
Original Article

Georg Thieme Verlag KG Stuttgart · New York

Abnormal Brushes in Preterm Infants with Periventricular Leukomalacia

H. Kidokoro1 , A. Okumura2 , K. Watanabe3
  • 1Department of Pediatrics, Kasugai Municipal Hospital, Kasugai, Japan
  • 2Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • 3Faculty of Medical Welfare, Aichi Shukutoku University, Nagoya, Japan
Further Information

Publication History

Received: March 22, 2006

Accepted after Revision: August 10, 2006

Publication Date:
18 January 2007 (online)

Abstract

Objective: The aim of this study is to describe a new objective method of detecting white matter injury by use of refiltering function of digital EEG. Study design: The neonatal EEGs of 9 patients with PVL were analyzed retrospectively, and compared with EEGs of 18 normal infants without PVL. Abnormal brushes were counted on the refiltered EEG where low cut filter were set at 10 Hz so that slow waves were eliminated. Abnormal brushes were defined as spindle-like fast wave bursts with maximal amplitudes higher than 40 mV and frequencies between 13 Hz and 20 Hz, which were easily distinguishable from a flat background. Results: The incidence of abnormal brushes in infants with PVL was 0.25/min, 0.45/min, 2.08/min, and 0.62/min on the frontal, central, occipital, and temporal region, respectively. The incidence in infants without PVL was 0.14/min, 0.08/min, 0.24/min, and 0.19/min, respectively. Abnormal brushes were observed more often in infants with PVL on the central, occipital, and temporal region than in infants without PVL. Localization of abnormal brushes was also correlated with the lesion of white matter injury on MR images and clinical outcome. Conclusion: Our results indicated that abnormal brushes on refiltered EEGs were strongly associated with white matter injury.

References

  • 1 Volpe J J. The developing nervous system: a series of review articles.  Pediatr Res. 2001;  50 553-562
  • 2 Dammann O, Leviton A. Maternal intrauterine infection, cytokines, and brain damage in the preterm newborn.  Pediatr Res. 1998;  42 1-8
  • 3 Watanabe K, Hayakawa F, Okumura A. Neonatal EEG: powerful tool in the assessment of brain damage in preterm infants.  Brain and Development. 1999;  21 361-372
  • 4 Biagioni E, Bartalena L, Boldrini A, Pieri R, Cioni G. Electroencephalography in infants with periventricular leukomalacia: prognostic features at preterm and term age.  J Child Neurol. 2000;  15 1-6
  • 5 Vermeulen R J, Sie L TL, Jonkman E J, Strijers R LM, Lafeber H N, Uitdehaag B MJ. et al . Predictive value of EEG in neonates with periventricular leukomalacia.  Dev Med Child Neurol. 2003;  45 586-590
  • 6 Hayakawa F. Okumura A. Kato T, Kuno K, Watanabe K. Determination of timing of brain injury in preterm infants with periventricular leukomalacia with serial neonatal electroencephalography.  Pediatrics. 1999;  104 1077-1081
  • 7 Okumura A, Hayakawa F, Kato T, Kuno K, Watanabe K. Positive rolandic sharp waves in preterm infants with periventricular leukomalacia: their relation to background electroencephalographic abnormalities.  Neuropediatrics. 1999;  30 278-282
  • 8 Baud O, Allest A M, Lacaze-Masmonteil T, Zupan V, Nedelcoux H, Boitbias C. et al . The early diagnosis of periventricular leukomalacia in premature infants with positive rolandic sharp waves on serial electroencephalography.  J Pediatr. 1998;  132 813-817
  • 9 Marret S, Parain D, Jeannot E, Eurin D, Fessard C. Positive rolandic sharp waves in the EEG of the premature newborn: a five-year prospective study.  Arch Dis Child. 1992;  67 948-951
  • 10 Novotny E J, Tharp B R, Coen R W, Bejar R, Enzmann D, Vaucher Y E. Positive rolandic sharp waves in the EEG of the premature infant.  Neurology. 1987;  37 1481-1486
  • 11 Aso K, Scher M S, Barmada M A. Neonatal electroencephalography and neuropathology.  J Clin Neurophysiol. 1989;  6 103-123
  • 12 Hayakawa F, Okumura A, Kato T, Kuno K, Watanabe K. Disorganized pattern: Chronic-stage EEG abnormality of the late neonatal period following severely depressed EEG activities in early preterm infants.  Neuropediatrics. 1997;  28 272-275
  • 13 Sofue A, Okumura A, Hayakawa F, Watanabe K. et al . sharp waves in preterm infants with periventricular leukomalacia.  Pediatr Neurol. 2003;  29 214-217
  • 14 Watanabe K. the neonatal electroencephalorgram and sleep-cycle patterns. Eyre JA The Neurophysiological Examination of the Newborn Infant. London; Mac Keith Press 1992: 11-47
  • 15 Cukier F, Ander M, Dreyfus-Brisac C. Apport de l'EEG au diagnostic des hemorragies intra-ventriculaires du prémature.  Revue d'electroencephalographie et de neurophysiologie clinique. 1972;  2 318-322
  • 16 Okumura A, Hayakawa F, Kato T, Maruyama K, Kubota T, Suzuki M. et al . Abnormal sharp transients on electroencephalograms in preterm infants with periventricular leukomalacia.  J Pediatr. 2003;  143 26-30
  • 17 Kubota T, Okumura A, Hayakawa F, Kato T, Itomi K, Kuno K. et al . Relation between the date of cyst formation observable on ultrasonography and the timing of injury determined by serial encephalography in preterm infants with periventricular leukomalacia.  Brain Dev. 2001;  23 390-394
  • 18 Kubota T, Okumura A, Hayakawa F, Kato T, Itomi K, Kuno K. et al . Combination of neonatal electroencephalography and ultrasonography: sensitive means in early diagnosis of periventricular leukomalacia.  Brain Dev. 2002;  24 698-702

Dr. Hiroyuki Kidokoro

Department of Pediatrics
Kasugai Municipal Hospital

1-1-1 Takaki-cho

Kasugai

Aichi, 486 - 8510

Japan

Email: kidokoro@wc4.so-net.ne.jp

    >