Case 5.2

An infant was born at 39 weeks gestation by emergency caesarean section due to fetal tachycardia. Apgar scores were 0, 0, and 0 at 1, 5, and 10 minutes, respectively. The baby required extensive resuscitation, with the heart rate only rising above 100 bpm at 20 minutes. At 3 hours, the Thompson score was 12, indicating severe encephalopathy. You connected the baby to the aEEG, which showed the following pattern:

You have to decide whether to start therapeutic hypothermia but see some changes of the lower margin to >5µV. How would you classify the background activity?

Do you think there are seizures at the time of the orange arrows?

After 48 hours, the aEEG looked a bit different with a change in background activity.

How would you describe this change in the background activity after 48 hours?