Case 6.2

This infant was born at 40 weeks gestation by elective caesarean section and did well after birth. There were difficulties feeding and the infant developed cyanotic spells. You connected the baby to the aEEG which showed the following.

How would you classify the background activity during the first three hours of the panel?

With a further look at the aEEG in the following panel, what do you think is seen at the arrow?

You watch the baby as there is another cyanotic spell, and see that there is unilateral tonic posturing followed by some clonic movements and again cyanosis. Together with the change in speed of the aEEG recording shown here, you are now making the preliminary diagnosis, which is:

As shown below, seizures continue and do not respond to phenobarbital.

What would be your next choice of treatment?