248 - Electroencephalogram Patterns on Follow-Up in Extremely Premature Infants with Periventricular Leukomalacia: An Observational Study

Poster Number: 248
Publication Number: 248.224

Rawad Obeid, Beacon Children's Hospital, Royal Oak, MI, United States; Sammie Lai, Oakland University William Beaumont School of Medicine, Beverly Hills, MI, United States

Background: Periventricular Leukomalacia (PVL) is a common brain injury in premature newborns. Current literature provides limited guidance on the benefit of electroencephalogram (EEG) as a potential screening tool for seizure risk in this population.

Objective: The purpose of this study is to describe the EEG patterns on follow-up visits in infants born premature with PVL.

Design/Methods: This is a retrospective study of premature newborns ( < 37 weeks gestation), who were followed in the neurodevelopmental clinic at Beaumont Children’s Hospital in Detroit MI between 2020 and 2022. Patient’s demographics, prematurity complications, head ultrasound (HUS), and EEG studies were reviewed. PVL on HUS was graded based on Agut et al 2020.

Results: 165 newborns met the inclusion criteria. Within them, 22 (13%) had PVL. 18 patients had grades 1-2 PVL while 4 had grade 3 based on serial HUS reviews. The mean gestational age was 26.5 ±2.3 weeks for PVL patients and 28 ±2.9 weeks for non-PVL (p=0.04). The mean birth weight for those without PVL was 1156 ±534 grams compared to 880 ±285.9 grams for PVL (p=0.04).  EEG was performed on 11/22 patients with PVL at a mean age of 20 months corrected age. EEG was normal in six patients (5/6 were grade 1), mildly slow background in two (one with grade 1 and one with grade 3). Three patients had multiple foci excessive sharp wave discharges (two with grade 3 and one with grade 2).Conclusion(s): PVL is a common brain injury in premature newborns. The relatively frequent association with an abnormal EEG should prompt providers to consider this test for seizure screening and early management.