An overview of an amplitude integrated EEG
Amplitude integrated EEG (aEEG) has been used widely in developed countries for years. It was initially developed by Maynard and Prior 1 in the early 1970s and later adapted for neonatal use by Hellstrom-Westas and Svenningsen 2 . It is especially used for monitoring term newborns after having survived from birth asphyxia.
During the last decade neonatal health care in Indonesia has developed. Monitoring of physiological parameters such as ECG, heart rate, blood pressure, oxygen saturation and temperature have been integrated in
our neonatal intensive care unit but equipments like continuous EEG monitoring and aEEG to evaluate brain function have not been well-known among our neonatologists and pediatricians. The consequence is the de-
crease of infant mortality was not associated with the improvement of quality of life of the survivors due to neurodevelopmental problems caused by various diseases during neonatal period. In the future, it can be prevented by using brain function monitoring in high risk newborn
for neurodevelopmental problem in conditions such as hypoxic-ischemic encephalopathy (HIE), prematurity, neonatal seizures, central nervous system infection, metabolic disorders, intraventricular or intracranial bleeding and brain malformation. This article gives an overview about aEEG and its role in newborn.
Weaver EJ, et al. Monitoring cerebral function: Clinical ex-
perience with new device of continuous recording of electri-
cal activity of brain. Br Med J 1971;2:736-8.
2. Bjerre I, Hellstrom-Westas L, Rosen I, Svenningsen NW.
Monitoring of cerebral function after severe asphyxia in in-
fancy. Arch Dis Child 1983;58:997-1002.
3. Murdoch-Eaton D, Darowski M, Livingstone J. Cerebral func-
tion monitoring in pediatric intensive care:useful features for
predicting outcome. Dev Med Child Neurol 2001;1:91-6.
4. Toet MC. Cerebral function monitoring in neonatal inten-
sive care [thesis]. Utrecht: University of Utrecht; 2005.
5. Vries LS, Hellstrom-Westas L. Role of cerebral function
monitoring in the newborn. Arch Dis Child Fetal Neonatal
6. Hellstrom-Westas L. Comparison between tape-recorded and
amplitude-integrated EEG monitoring in sick newborn in-
fants. Acta Paediatr 1992;81:812-9.
7. Verma UL, Archbald F, Tejani NA, Handwerker SM. Cere-
bral function monitoring in the neonate, I:Normal patterns.
Dev Med Child Neurol 1984;26:154-61.
8. Osredkar D, Toet MC, van Rooij LGM, van Huffelen AC,
Groenendaal F, De Vries LS. Slee-wake cycling on ampli-
tude integrated EEG in fullterm newborns with hypoxic
ischaemic encephalopathy. Pediatrics 2005;115:327-32.
9. Volpe JJ. Neurology of the newborn. 4 th ed. Philadelphia:
WB Saunders Company; 2000.
10. Kuhle S, Klebermass, Olischar, Hulek M, Prusa AR,
Kohlhauser C, et al. Sleep-wake cycle in preterm infants be-
low 30 weeks of gestational age. Preliminary results of a pro-
spective amplitude-integrated EEG study. Wien Klin
11. Groenendaal F, De Vries LS. Selection of babies for inter-
vention after birth asphyxia. Semin Neonatol 2000;5;17-
12. Toet MC, Hellstrom-Westass L, Groenendal F, Eken P, De Vries
LS. Amplitude integrated EEG at 3 and 6 hours after birth in
fullterm neonates with hypoxic ishaemic encephalopathy. Arch
Dis Child 1999;81: F19-23.
13. Eken P, Toet MC, Groenendal F, De Vries LS. Predictive value
of early neuroimaging, pulsed Doppler and neurophysiology
in full term infants with hypoxic-ischaemic encephalopathy.
Arch Dis Child 1995;73: F75-80.
14. Hellstrom-Westas L, Rosen I, Sveningsen NW. Predictive
value of early continuous amplitude integrated EEG record-
ings on outcome after severe birth asphyxia in full term in-
fants. Arch Dis Child Fetal neonatal Ed.1995;72:F34-8.
15. Ter Horst HJ, Sommer C, Bergman KA. Prognostic signifi-
cance of amplitude-integrated EEG during the first 72 hours
after birth in severely asphyxiated neonates. Pediatr Res
16. Boylan GB, Pressler RM, Rennie JM, Morton M, Leow PL,
Hughes R, et al. Outcome of electroclinical, electrographic,
and clinical seizures in the newborn infants. Dev Med &
Child Neur 1999;41:819-25.
17. Sher MS, Alvin J, Gaus L, Minnigh B, Painter MJ. Uncou-
pling of EEG-clinical neonatal seizures after antiepileptic drug
use. Pediatr Neurol 2003;28:277-80.
18. Miller SP, Weiss J, Barnwell A, Ferriero DM, Latal-Hajnal
B, Ferrer-Rogers A, et al. Seizure-associated brain injury in
term newborns with perinatal asphyxia. Neurology
19. Mc Bride MC, Laroia N, Guillet R. Electrographic seizures
in neonates correlate with poor neurodevelopmental out-
come. Neurology 2000;55:506-13.
20. Shany E, Khvatsin S, Golan A, Karplus M. Amplitude-inte-
grated electroencephalography:A tool for monitoring silent
seizures in neonates. Pediatr Neurol 2006;34: 194-9.
21. Stockard-Pope JE, Werner SS, Brickford RG. Atlas of neo-
natal electroencephalography. New York: Raven Press; 1992.
22. Toet MC, van der Meij W, de Vries LS, Uiterwall CSPM,
van Huffelen AC. Comparison between simultaneous re-
corded amplitude integrated EEG and standard EEG in neo-
nates. Pediatrics 2002;109:772-9.
23. Clancy RR, Legido A. Postnatal epilepsy after EEG-confirmed
neonatal seizures. Epilepsia 1991;32: 69-76.
24. Brunquell PJ, Glennon CS, Dimario FJ, Lerer T, Eisenfeld L.
Prediction of outcome based on clinical seizure type in new-
born infants. J Pediatr 2002;140: 707-12.
25. Toet MC, Groenendall F, Osredkar D, van Huffelen AC, de
Vries LS. Post neonatal epilepsy following aEEG detected
neonatal seizures. Pediatr Neurol 2005;32:241-7.
26. Hellstrom-Westas L, Rosen I. Amplitude-integrated electro-
encephalogram in newborns infants for clinical and research
purposes. Acta pediatr 2002;91:1028-30.
27. Burdjalov VF, Baumgart S, Spitzer AR. Cerebral function
monitoring system for the evaluation of brain maturation
system for the evaluation of brain maturation in neonates.
28. Rennie JM, Chorley G, Boylan GB, Pressler R, Nguyen Y,
Hooper R. Non-expert use of the cerebral function moni-
tor for neonatal seizure detection. Arch Dis Child Fetal
Authors who publish with this journal agree to the following terms:
Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.