Refining Neonatal Continuous EEG Guidelines Through Evidence and Family Collaboration: Adam Numis, MD

WATCH TIME: 3 minutes

"Our goal was to identify which neonates truly benefit most from continuous EEG monitoring, and to ensure future guidelines balance clinical value with the family’s perspective and the infant’s overall wellbeing."

In 2024, a working group was formed from ACNS membership with expertise in neonatal continuous EEG (cEEG) to develop updated guidelines on the use of cEEG in this patient population. The study authors, which included Adam Numis, MD, outlined when cEEG monitoring is appropriate and emphasized the importance of improving neonatal seizure diagnosis and neurodevelopmental outcome assessment.

Numis, an associate professor of neurology and pediatrics at the University of California, San Francisco, gave a talk at the 2025 Child Neurology Society (CNS) Annual Meeting, held October 8-11, in Charlotte, North Carolina, about the updated guidelines, and their implications on clinical care. In his talk, he emphasized how this newer version, an update to the 2011 document, was developed using systematic, GRADE-based methodology to establish best practices for seizure monitoring in high-risk newborns.

During the meeting, Numis sat down with Contemporary Pediatrics, a sister publication to NeurologyLive® about the session, and how the newly updated recommendations refine or alter which high risk neonates undergo cEEG. he updated analysis supports cEEG use with moderate evidence in neonates undergoing ECMO post–cardiac surgery and those with hyperammonemia of genetic origin, while providing conditional recommendations with weaker evidence for more common conditions such as hypoxic-ischemic encephalopathy and perinatal stroke.

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