The effect of treatment of neonatal electrographic seizures, detected with the continuous cerebral function monitoring, with respect to occurrence of postneonatal epilepsy and neurodevelopmental outcome.

Neonatal seizures are commonly seen following perinatal asphixia. Since the introduction of the continuous bedside simplified EEG monitoring devices, it has become clear that subclinical seizures occur in about 50-60% of all neonatal seizures.
As yet it is not known whether treatment of these subclinical seizures is necessary and will improve longterm outcome.
Treatment of neonatal seizures is a challenge and the most commonly used anti-epileptic drugs are only effective in about 50% of the cases.
To resolve the problem whether treatment of subclinical seizures is required or unnecessary and maybe even deleterious to the developing brain, a randomised controlled trial (RCT) is performed.
In the randomised trial infants will be either treated with antiepileptic drugs when they have clinical as well as subclinical seizures, as detetected on the amplitude integrated EEG.
In the other arm, only clinical seizures will be treated and the aEEG will record but will be blinded.

We hypothesize that without continuous EEG registration, subclinical electrographic seizures will be missed. Repetive ictal seizures and a sublcinical status epilepticus may be deleterious to the immature brain. On the other hand the use of antiepileptic drugs may also have adverse effects, especially to the developing brain.

N/A

Following initiation of aEEG registration and the occurrence of the first subclinical seizure, and following parental consent, the infant will be randomised to group A (treatment of clinical as well subclinical seizures as detetected on the aEEG) or group B (the aEEG will be blinded, and only clinical seizures will be treated;
Intermittent standard EEG can be performed and in case the EEG shows a status epilepticus this can be treated, but in case a subclinical seizure is seen on the standard EEG, this will not be treated with anti-epileptic drugs).