Case 6.4

An infant born at 34 weeks gestation via caesarean section due to decreased fetal movements and a biophysical profile of 2/8. Delivery was complicated by confirmed placental abruption. The infant was admitted to the NICU and received surfactant for RDS, stabilizing on CPAP. On day 2, the infant developed frequent apneas, desaturations, and hypotonia, requiring stimulation and increasing FiO2. Apneic episodes did not resolve with a caffeine bolus. Head ultrasound (HUS) was normal, and the aEEG showed the following pattern:

Does the aEEG tracing show seizures?

Raw EEG is demonstrated in Fig Q6.4.2 and seizures were confirmed.

This baby received one dose of lorazepam for initial seizure control and then responded to a loading dose of phenobarbital.

Here is the aEEG tracing post-treatment:

What mode of imaging would you do to that baby?