Neonatal Flashcards

1
Q

order of EEG maturational changes in neonate

A

Active sleep > awake > quiet sleep

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2
Q

Synchrony by age:
A)
B)
C)
Abnormal finding:

A

Synchrony by age:
A) - <28 weeks = no asynchrony
B) - 28-32 weeks; 70% syncrony
C) > 37 weeks: mostly synchronus
Abnormal finding: Asyhcrony of >1.5 s

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3
Q

% of patients with normal development in:
HIE:
IVH:
SAH:
Infections:
Cerebral malformations:
metabolic disorders:

A

% of patients with normal development in:
HIE: 50%
IVH: 10%
SAH: 90%
Infections: 50%
Cerebral malformations: 0%
metabolic disorders: Transient: 50-100%

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4
Q

Neonatal seizure likelihood:
Focal and multifocal CLONIC:
Focal and generalized TONIC:
Myoclonic:
Subtle seizure pattern:
name 7 subtle seizure patterns:

A

Neonatal seizure likelihood:
Focal and multifocal CLONIC: 25%
Focal and generalized TONIC: 5%
Myoclonic: 20%
Subtle seizure pattern: 50%
name 7 subtle seizure patterns:
- Apnea
- Tonic deviation of the eyes
- Eyelid fluttering
- Drooling, sucking, chewing
- swimming movements of the arm
- pedaling movements of the legs
- paroxysmal laughing

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5
Q

Pyridoxine dependent epilepsy:
age of presentation (name two)

A

Pyridoxine dependent epilepsy:
age of presentation (name two)
- neontatal: Shortly after birth
- Atypical: 1 and 3 years

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6
Q

Pyridoxine Dependent epilepsy:
Testing:
Lab #1 (+ 2 locations)
Lab #2 (+ 2 locations)
Gene

A
  • elevated alpha-aminoadipic semialdehyide (a-AASA) in urine / plasma
  • elevated pipecolic acid in Plasma and CSF
  • Mutation in ALDH7A1
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7
Q

Pyridoxine dependent epilepsy:
Treatment (+ Dose)

A

Folinic acid at 4 mg/kg/day divided BID

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8
Q

Voltage ranges for Trace discontinue

A

High amplitude bursts: 50-300 uV
“quiescence” (<25 uV)

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9
Q

Inter-burst intervals:
- duration associated with higher SURVIVAL in 30+weeks:

A

8 Seconds or less

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10
Q

conceptual age in which you begin seeing varation

A

35 weeks

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11
Q

In neonates, where are you most likely to see abnormalities (and why?)

A

Quiet sleep (last stage to see maturational changes)

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12
Q

Normal vs Abnormal Sharp transients in neonatal EEG
- Location
- morphology
- polarity
- amplitude
- duration
- In what stage?

A

Normal vs Abnormal Sharp transients in neonatal EEG
- Location
- Normal: Bitemporal / central
- Abnormal: one persistent location
- morphology
- Normal: monophasic / Diphasic
- Abnormal: variable / polyphasic
- polarity
- normal: negative
- abnormal: negative OR positive
- amplitude
- Norma: <75 uV
- Abnormal: >150 uV
- duration
- Normal: <100 ms
- >150 ms
- In what stage?
- Normal: quiet sleep
- Abnormal: awake and quiet sleep

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13
Q

Trace Alternans
- When do you typically see it?
- When is it ABNORMAL to see it?
- what replaces this pattern?

A

Trace Alternans
- When do you typically see it? 35w-42w
- When is it ABNORMAL to see it? 42+ weeks
- what replaces this pattern? medium-t-high voltage delta slow during sleep

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14
Q

Benign myoclonic epilepsy of infancy (BMEI)
Sex:
Treatment of choice:
Family history can be positive for…

A

Benign myoclonic epilepsy of infancy (BMEI)
Sex: males > females
Treatment of choice: Valproate
Family history can be positive for febrile seizures or epilepsy

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15
Q

Factor favored to explain why neonatal seizures are difficult to treat

A

Excitatory nature of GABA signaling (why Gaba agonists are often inneffective)

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16
Q

Inter-burst intervals:
- Typical IBI / voltages between 30-33 weeks
- Typical IBI / voltages 34 weeks - Term

A

30-33 weeks
- IBI: 20-35 seconds
- Voltages: <25 seconds
34 weeks
- IBI: 6-10 seconds
- Voltages >25 seconds

17
Q

Rhythmic temporal Theta
- When do you start seeing it?
- When is it most prominent?
- When does it disappear?

A
  • Start seeing at 26 weeks
  • Most prominent 30-32 weeks
  • disappear after 33 weeks
18
Q

Encoche frontales
- AKA
- when do you first see it?
- When does it disappear?

A
  • AKA frontal sharp transients
  • Begin to see it at 34 weeks
  • Disappear around 44 weeks
19
Q

Monorhythmic occipital delta
- When do you start seeing it?
- when is it most prominent?
- when does it disappear?

A
  • begin seeing it at 23-24 weeks
  • most prominent 31-33 weeks
  • disappear after 35 weeks
20
Q

Delta brushes
- when do you start seeing it?
- when is it most prominent (active sleep)
- When is it most prominent (quiet sleep)
- when does it disappear?

A
  • Start seeing it at 26 weeks
  • most prominent (active sleep): 29-33 weeks
  • most prominent (quiet sleep): - 33-38 weeks
  • disappear by 48 weeks