An introduction to neonatal EEG

Electroencephalography (EEG) is used in neonatal care to assess encephalopathy, seizure recognition and classification, to make epilepsy syndrome diagnoses and to assess the maturity of neonatal brain activity. A basic understanding of the EEG is very helpful in ensuring that clinicians gain as much information as possible from this helpful, non-invasive investigation. The neonatal EEG is complex and accurate reporting requires detailed clinical information to be provided on request forms. Even when this is provided EEG reports are frequently returned to the neonatal unit loaded with technical details, making it difficult for neonatal staff to fully understand them. This article reviews the basics of EEG, the changes seen with increasing gestational age, and changes seen in common pathologies. We also provide a structured approach to the interpretation of the neonatal EEG report, and discuss its role in prognostication. Amplitude integrated EEG is reviewed in our companion paper.