신생아집중치료실에서 신생아 발작을 진단하기 위해 시행되는 Amplitude integrated electroencephalography에 대한 고찰 = Amplitude Integrated Electroencephalography in the Neonatal Intensive Care Unit for Diagnosis of Neonatal Seizure

국문 초록 (Abstract)

목적 : 신생아집중치료실에 입원하여 신생아 경련이 의심되어 aEEG (Amplitude-integrated elect-roencephalography)와 EEG (electroencephalo-graphy)를 시행한 신생아들을 대상으로 하여 신생아 경련을 진단하는데 있어서 aEEG의 선별도구로서의 유용성을 평가하고자 하였다.
방법 : 2009년 1월부터 2010년 2월까지 신생아 집중치료실에 입원하여 임상적으로 경련발작이 있거나 아미노필린과 지속적 양압환기에도 반응하지 않는 무호흡이 있어 신생아 경련이 의심되는 환아 24명의 aEEG 결과와 EEG 결과, 뇌초음파 결과를 비교하였다.
결과 : aEEG 결과에서는 15명(62.6%)은 경련양상(seizure pattern)이 있었으며 평평한 양상(flat pattern)은 2명(8.3%), 돌발파 억제 양상(burst suppression)이 2명(8.3%), 정상(continuous nor-mal voltage)은 5명(20.8%)이었다. EEG 결과에서는 15명(62.5%)은 신생아 경련, 2명(8.3%)은 대뇌 기능 장애, 7명(29.1%)은 정상소견을 보였다. 총 24명의 환아 중 15명이 신생아 경련으로 진단되었다. 임상적으로 경련 발작이 있거나 아미노필린과 양압환기에도 반응하지 않는 무호흡이 있어 신생아 경련이 의심되어 aEEG를 시행한 24명의 환아의 aEEG결과와 EEG결과와의 상관관계는 통계적으로 유의하였다(Kappa=0.56, P value<0.05). aEEG를 시행한 환아 24명중 19명(79.2%)에서 비정상 결과를 보였으며 비정상 결과를 보인 19명의 뇌초음파에서 의미 있는 결과는 2명(두개내 출혈이 1명, 뇌부종이 1명)으로 두 검사간의 상관관계는 없었다.
결론 : 신생아 경련의 진단에 있어 환아 바로 옆에서 지속적으로 감시가 가능 한 aEEG는 EEG를 시행하기 전 선별검사로서 의의가 있었다.

다국어 초록 (Multilingual Abstract)

Purpose : To assess the usefulness of amplitude integrated electroencephalography (aEEG), we compared aEEG with electroencephalography (EEG), which is one of the most useful tools for assessment of neonatal seizures in the neonatal intensive care unit.
Methods : We retrospectively studied 24 neonates who had been suspected of seizure activity in the neonatal intensive care unit from January 2009 to February 2010. The 24 neonates had seizure or apnea that did not respond to aminophylline or continuous positive airway pressure. We compared the correlation and efficacy of diagnosis among aEEG, EEG, and neurosonography.
Results : We analyzed 24 aEEGs in the neonatal intensive care unit. The aEEGs showed a seizure pattern in 15 (62.6%), burst suppression pattern in 2 (8.3%), flat pattern in 4 (8.3%), and normal in 5 (20.8%). The results of EEGs showed 15 neonatal seizures (62.5%), 2 cerebral dysfunctions (8.3%), and 7 normal findings (29.2 %). A correlation between aEEG and EEG was noted (P＜0.05). However, there was no correlation between the results of aEEG and echoencephalography.
Conclusion: There is correlation between aEEG and EEG for seizure detection in the neonatal intensive care unit. We think that aEEG is an useful screening tool for seizure detection in neonates.

목차 (Table of Contents)

• Abstract
• 서론
• 대상 및 방법
• 결과
• 고찰
• 요약
• References

참고문헌 (Reference)

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