Epileptic seizures in newborns are among the most common neurological emergencies in early life, yet their long‑term consequences are difficult to predict. While many seizures are transient, some infants go on to develop epilepsy later in life. A new study by Panagiota Karatza, Dorottya Cserpan, Georgia Ramantani and colleagues at the University Children’s Hospital Zurich shows that fast brain signals can help distinguish newborns with seizures from healthy infants. These signals may also help identify babies at higher risk of developing epilepsy later in life.
Seizures in newborns are usually detected using electroencephalography (EEG), which records electrical brain activity from electrodes placed on the scalp. However, standard EEG features do not reliably indicate which infants will later develop postneonatal epilepsy (epilepsy starting after the first weeks of life). The researchers asked whether scalp high‑frequency activity (HFA) – brief bursts of fast brain signals above 80 Hz – could serve as an objective biomarker of seizure burden and future epilepsy risk. The team quantified HFA rates with EEG sleep recordings from 47 newborns with confirmed seizures and eight healthy newborns.
The results show that newborns with seizures had markedly higher HFA rates than healthy newborns. Among newborns with seizures, HFA rates varied by cause: they were higher in newborns with early-onset genetic epilepsies and lower in those with structural vascular lesions. The data suggest that HFA primarily reflects seizure‑related brain activity, as it was not influenced by general EEG background abnormalities or by treatments used in some newborns. Most strikingly, newborns who later (after the first weeks of life) developed epilepsy showed significantly higher HFA rates than those with normal development, suggesting that these fast brain signals could be a tool for identifying the risk of recurrent seizures early on.
These findings highlight HFA as a promising, noninvasive marker for assessing seizures in newborns. Although larger studies are still needed to confirm these results before clinical implementation, automated analysis of routine EEG recordings could help identify newborns at higher risk earlier and support improved long‑term outcomes.
Reference: Karatza P, Lo Biundo S, Sarnthein J, Cserpan D, Rüegger A, Pisani F, Ramantani G. Scalp high‑frequency activity differentiates neonates with seizures from healthy neonates and indicates postneonatal epilepsy risk. Epilepsia. 2025. https://doi.org/10.1111/epi.70025
Useful links:
- Cserpan D, Guidi G, Alessandri B, Fedele T, Rüegger A, Pisani F, Sarnthein J, Ramantani G. Scalp high-frequency oscillations differentiate neonates with seizures from healthy neonates. Epilepsia Open. 2023; https://doi.org/10.1002/epi4.12827
- Cserpan D, Boran E, Lo Biundo SP, Rosch R, Sarnthein J, Ramantani G. Scalp high-frequency oscillation rates are higher in younger children. Brain Commun. 2021; https://doi.org/10.1093/braincomms/fcab052
- Pisani F, Spagnoli C, Falsaperla R, Nagarajan L, Ramantani G. Seizures in the neonate: A review of etiologies and outcomes. Seizure. 2021; https://doi.org/10.1016/j.seizure.2020.12.023
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