Prolonged electroencephalogram monitoring for seizures and their treatment

Examining cerebral cortical function in an awake, cooperative adult is a reasonably easy, straightforward task. Cognitive function can be reliably determined by the assessment of orientation, receptive and expressive language, memory, problem solving, mathematical skills, and proverb interpretation. These traditional cognitive tasks are sensitive measures of the integrity of cerebral cortical functioning. In contrast, the same task is daunting in even the healthiest newborn infants. Even in an awake, well newborn infant, no reliable bedside clinical tools demonstrate the health of the cerebral cortex. Because the electroencephalogram (EEG) is exclusively generated by the outermost layers of the cerebral cortex, careful examination of the integrity of the EEG is a sensitive, albeit nonspecific yardstick for measuring the health of the cortex of the immature central nervous system [1]. In the past decades, many studies have confirmed the value of routine neonatal EEG examinations in assessing brain maturity, sleep cycling, the presence and severity of encephalopathy, and seizures [2-4].