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Epileptički napadi su najčešći neurološki poremećaj kod novorođenčadi i često prvi znak neurološke disfunkcije. Oni su predmet mnogih naučnih i kliničkih ispitivanja zbog njihovog snažnog prediktivnog uticaja na kognitivna i razvojna oštećenja. Etiologija neonatalnih napada je veoma heterogena, uglavnom akutna reaktivna. Veoma je važno odrediti uzroke neonatalnih napada, jer etiologija ima značajan uticaj na prognozu i ishod i utiče na dalje terapijske strategije. Ciljevi: Procena dugoročnog ishoda i utvrđivanje prediktora prognoze kod dece sa neonatalnim napadima. Materijal i metode: Retrospektivna studija je obuhvatila novorođenčad sa epileptičkim napadima koja su se lečila u Institutu za zdravstvenu zaštitu majke i deteta Srbije “Dr Vukan Čupić” u Beogradu od 1. januara 2005. godine do 31. decembra 2015. godine. Podaci su dobijeni iz istorija bolesti i baze podataka elektroencefalograma (EEG). Procenjena je prediktivna vrednost sledećih parametara: karakteristike pacijenata (pol, gestacijska starost, telesna masa na rođenju, ocean na rođenju, primena mehaničke ventilacije), etiologija, karakteristike napada (tip, vreme početka, farmakorezistencija) i EEG nalaz (osnovna aktivnost, paroksizmalne promene). Ishod neonatalnih napada je procenjen na kraju perioda praćenja i kategorisan je kao smrtni ishod, neurološki nalaz, razvojni količnik i epilepsija. Univarijantna i multivarijantna logistička regresiona analiza korišćene su za procenu prediktora ishoda neonatalnih napada. Rezultati: Ispitivanjem je obuhvaćeno 168 novorođenčadi (109 muškog pola, 59 ženskog pola) sa epileptičkim napadima, prosečnog uzrasta 4 godine (SD 3.4) na kraju praćenja (opseg 1-12 godina). Normalni neurološki razvoj bez epilepsije zabeležen je kod 131 pacijenta (78%), neurološke abnormalnosti kod 31 (19,0%), nepovoljan razvojni količnik kod 28 (17,2%), epilepsija kod 12 (7,4%) i smrtni ishod kod 7 pacijenata (4,17%). Zaključak: Dugotrajni ishod kod dece sa neonatalnim napadima je povoljan. Nov, Neonatal seizures are the most common neurological disorder in newborns, and often the first sign of neurologic dysfunction. The seizures in neonatal period are the subject of many scientific and clinical investigations due to their powerful predictor value of long-term cognitive and developmental impairment. The etiology of neonatal seizures is very heterogeneous, mostly acute reactive. It is very important to determine causes of neonatal seizures, since etiology has significant impact on prognosis and outcome and influences further therapeutic strategies. Objectives: Evaluation of long-term outcome and assesment of predictors of prognosis in children with neonatal seizures. Matherial and methods: The retrospective study included children with neonatal seizures treated in the Mother and child health care Institute “Dr Vukan Čupić” in Belgrade, from January the 1st 2005 to December the 31st 2015. The data were collected from medical charts and database of electroencephalograms (EEG). The predictive value of following parameters was evaluated: characteristics of the patients (gender, gestational age, birth body weight, Apgar score, artificial ventilation), etiology, characteristics of seizures (type, time of onset, resistance to tretment) and EEG (background activity, paroxysmal discharges). The outcome of neonatal seizures was assessed at the end of follow-up period and was categorized as lethal outcome, neurological abnormalities, intellectual disability and epilepsy. Univariate and multivariate logistic regression analyses were used to assess predictors of neonatal seizures outcome. Results: The study included 168 (male 109, female 59) children with neonatal seizures, mean aged 4 (SD 3.4) years at the end of the follow up (range 1-12 years). There was normal neurological development without epilepsy in 131 patients (78%), neurological abnormality in 31 (19.0%), intellectual disability in 28 (17.2%), epilepsy in 12 (7.4%) and lethal outcome in 7 patients (4.17%). C

Objective: To describe the characteristics of activity bursts in the early preterm EEG, to assess inter-rater agreement of burst detection by visual inspection, and to determine the performance of an automated burst detector that uses non-linear energy operator (NLEO). Methods: EEG recordings from extremely preterm (n = 12) and very preterm (n = 6) infants were analysed. Three neurophysiologists independently marked bursts in the EEG, the characteristics of bursts were analyzed and inter-rater agreement determined. Unanimous detections were used as the gold standard in estimating the performance of an automated burst detector. In addition, some details of this automated detector were revised in an attempt to improve performance. Results: Overall, inter-rater agreement was 86% for extremely preterm infants and 81% for very preterm infants. In visual markings, bursts had variable lengths (similar to 1-10 s) and increased amplitudes (and power) throughout the frequency spectrum. Accuracy of the original detection algorithm was 87% and 79% and accuracy of the revised algorithm 93% and 87% for extremely preterm and very preterm babies, respectively. Conclusion: Visual detection of bursts from the early preterm EEG is comparable albeit not identical between raters. The original automated detector underestimates the amount of burst occurrence, but can be readily improved to yield results comparable to visual detection. Further clinical studies are warranted to assess the optimal descriptors of burst detection for monitoring and prognostication. Significance: Validation of a burst detector offers an evidence-based platform for further development of brain monitors in very preterm babies.