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An electroencephalogram (EEG) is a useful ancillary and diagnostic test that detects electrical activity in the brain. The neonatal EEG can be quite challenging and may require additional skills and training, given that benign variants exist within the different stages of development and must be differentiated from abnormal discharges. This activity describes neonatal visual analysis on EEG and highlights the role of the healthcare team in evaluating patients who undergo EEG. Objectives: Identify the anatomical structures, indications, and contraindications of neonatal visual analysis on EEG. Outine the equipment, personnel, preparation, and technique in regards to neonatal visual analysis on EEG. Describe the appropriate evaluation of the potential complications and clinical significance of neonatal visual analysis on EEG. Discuss interprofessional team strategies for improving care coordination and communication during neonatal visual analysis on EEG and improve outcomes. Access free multiple choice questions on this topic.

A conventional electroencephalogram (EEG) is a useful ancillary and diagnostic test that detects the electrical activity of the brain. Electrodes are placed in the scalp and connected to the EEG recording instrument, with a standard set consisting of 21 recording electrodes and one ground (reference) electrode. Odd numbers refer to left-sided and even numbers to right-sided electrodes. The letter designations refer to the different cortical areas (F-frontal, C-central, T-temporal, O-occipital, Z-midline). The neonatal EEG is useful for determining brain development, identify cortical hyperexcitability, epileptiform activity, or seizures. The analysis can be quite challenging and may require additional skills and training, given that benign variants exist within the different stages of development and must be differentiated from abnormal discharges. For a neonatal EEG, equipment modifications include eight scalp electrodes (FP1, C3, T3, O1, FP2, C4, T4, O2) and lower recording speed. Visual analysis is the gold standard for clinical interpretation of the neonatal EEG.[1][2] Individual variability is an essential factor when extracting clinically relevant features by visual analysis of the EEG signals.[3][4] Although automated software can identify EEG signals, human extraction, and analysis of the clinical information by visual analysis is an essential part of the overall recording. The visual analysis will provide a complete description of the most salient features of the EEG to give an interpretation, a conclusion, and a clinical correlation. This article describes the visual analysis technique in neonates.

Complications are common during extensive monitoring and include the following: Skin breakdown Skin infections The use of moisturizers, gel, and topical antibiotics can preserve skin and avoid infections.

An interdisciplinary neonatal team of pediatric neurologists, clinical pediatric neurophysiologists, pediatric critical care specialists, neonatal nurses, and respiratory therapists should work together to achieve an optimal video EEG recording. Documentation of clinical symptoms, current medications, topography, gestational age, corrected age, and state of the infant, among other clinical data, is essential and should be conveyed to the EEG reader for accurate study interpretation. Protocols should be in place to assist and facilitate coordination of care. [Level 1]