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DOI: 10.1055/a-1877-9291
An Amplitude-Integrated EEG Evaluation of Neonatal Opioid Withdrawal Syndrome
Funding The Barnes-Jewish Hospital Foundation and the Washington University Institute of Clinical and Translational Sciences provided funding for this study (NIH/NCATS UL1 TR000448).![](https://www.thieme-connect.de/media/ajp/2024S01/lookinside/thumbnails/10-1055-a-1877-9291_210790-1.jpg)
Abstract
Objective Infants with neonatal opioid withdrawal syndrome (NOWS) have disrupted neurobehavior that requires hospitalization and treatment. This article aimed to evaluate electroencephalography (EEG) abnormalities using amplitude-integrated EEG (aEEG) in NOWS.
Study Design Eighteen term born infants with NOWS were recruited prospectively for an observational pilot study. aEEG monitoring was started within 24 hours of recruitment and twice weekly through discharge. aEEG data were analyzed for background and seizures. Severity of withdrawal was monitored using the modified Finnegan scoring (MFS) system.
Results Fifteen neonates had complete datasets. Thirteen (87%) had continuous aEEG background in all recordings. None had sleep–wake cyclicity (SWC) at initial recording. Brief seizures were noted in 9 of 15 (60%) infants. Lack of SWC was associated with higher MFS scores. At discharge, 8 of 15 (53%) had absent or emerging SWC.
Conclusion aEEG abnormalities (absent SWC) are frequent and persist despite treatment at the time of discharge in the majority of patients with NOWS. Brief electrographic seizures are common. Neonates with persistent aEEG abnormalities at discharge warrant close follow-up.
Key Points
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EEG abnormalities are common and persist after clinical signs resolve in patients with NOWS.
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Short subclinical seizures may be seen.
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aEEG may identify neonates who need follow-up.
Keywords
amplitude-integrated EEG - neonatal opioid withdrawal syndrome - neonatal sleep–wake cyclicity - neonatal seizures - modified Finnegan scoreAuthors' Contributions
C.L. conceptualized and designed the study, organized data collection, enrolled patients and collected data, conducted statistical analysis, drafted the initial manuscript, and reviewed and revised the manuscript.
Z.V. assisted with data analysis, reviewed, and revised the final manuscript.
J.Z. assisted with analyzing aEEG data and reviewed/edited the final manuscript.
H.G. conducted statistical analysis and reviewed the manuscript.
S.L. was the second independent blinded reviewer of the aEEG traces.
R.R. assisted with study design, reviewed, and revised the final manuscript.
A.M.M. conceptualized design of the study and data collection process, and critically reviewed and revised the final manuscript for important intellectual content.
All authors approved the final manuscript as submitted and agreed to be accountable for all aspects of the work.
Publikationsverlauf
Eingereicht: 21. Oktober 2021
Angenommen: 01. Juni 2022
Accepted Manuscript online:
16. Juni 2022
Artikel online veröffentlicht:
12. September 2022
© 2022. Thieme. All rights reserved.
Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA
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