Optimizing Detection Rate and Characterization of Subtle Paroxysmal Neonatal Abnormal Facial Movements with Multi-Camera Video-Electroencephalogram Recordings

Abstract

Objectives We retrospectively analyze the diagnostic accuracy for paroxysmal abnormal facial movements, comparing one camera versus multi-camera approach.

Background Polygraphic video-electroencephalogram (vEEG) recording is the current gold standard for brain monitoring in high-risk newborns, especially when neonatal seizures are suspected. One camera synchronized with the EEG is commonly used.

Methods Since mid-June 2012, we have started using multiple cameras, one of which point toward newborns' faces. We evaluated vEEGs recorded in newborns in the study period between mid-June 2012 and the end of September 2014 and compared, for each recording, the diagnostic accuracies obtained with one-camera and multi-camera approaches.

Results We recorded 147 vEEGs from 87 newborns and found 73 episodes of paroxysmal facial abnormal movements in 18 vEEGs of 11 newborns with the multi-camera approach. By using the single-camera approach, only 28.8% of these events were identified (21/73). Ten positive vEEGs with multicamera with 52 paroxysmal facial abnormal movements (52/73, 71.2%) would have been considered as negative with the single-camera approach.

Conclusions The use of one additional facial camera can significantly increase the diagnostic accuracy of vEEGs in the detection of paroxysmal abnormal facial movements in the newborns.

Keywords

vEEG - newborn - subtle seizures - paroxysmal nonepileptic events - detection rate

Ethical Approval

Local ethics committee approval was obtained.

• References

• 1 Shellhaas RA. Continuous long-term electroencephalography: the gold standard for neonatal seizure diagnosis. Semin Fetal Neonatal Med 2015; 20 (3) 149-153
• 2 Hahn JS, Sanger T. Neonatal movement disorders. Neoreviews 2004; 5: e321-e326
• 3 Pisani F, Cerminara C, Fusco C, Sisti L. Neonatal status epilepticus vs recurrent neonatal seizures: clinical findings and outcome. Neurology 2007; 69 (23) 2177-2185
• 4 Pisani F, Sisti L, Seri S. A scoring system for early prognostic assessment after neonatal seizures. Pediatrics 2009; 124 (4) e580-e587
• 5 Orivoli S, Facini C, Pisani F. Paroxysmal nonepileptic motor phenomena in newborn. Brain Dev 2015; 37 (9) 833-839
• 6 Clancy RR, Legido A. The exact ictal and interictal duration of electroencephalographic neonatal seizures. Epilepsia 1987; 28 (5) 537-541
• 7 Chang T, Tsuchida TN. Conventional (continuous) EEG monitoring in the NICU. Curr Pediatr Rev 2014; 10 (1) 2-10
• 8 Malone A, Ryan CA, Fitzgerald A, Burgoyne L, Connolly S, Boylan GB. Interobserver agreement in neonatal seizure identification. Epilepsia 2009; 50 (9) 2097-2101
• 9 Boylan GB, Stevenson NJ, Vanhatalo S. Monitoring neonatal seizures. Semin Fetal Neonatal Med 2013; 18 (4) 202-208
• 10 Berg AT, Berkovic SF, Brodie MJ , et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia 2010; 51 (4) 676-685
• 11 Pisani F, Spagnoli C, Pavlidis E , et al. Real-time automated detection of clonic seizures in newborns. Clin Neurophysiol 2014; 125 (8) 1533-1540