The Dammiss EEG Score: A New System to Quantify EEG Abnormalities and Predict the Outcome in Asphyxiated Newborns

Background: The aim of the study was to evaluate a novel EEG scoring system as a diagnostic and prognostic tool for brain injury in infants who had experienced perinatal asphyxia. Methods: The scoring system, based on a semi-quantitative approach, encompassed seven EEG parameters and their aggregate Dammiss score (DS) measured across seven time points (6 h, 12 h, 24 h, 48 h, 72 h, 78 h, and 2 weeks). The EEGs of 61 full-term newborns affected by perinatal asphyxia and treated with therapeutic hypothermia were evaluated. Results: The EEG parameters were correlated with the outcome at 2 years of age: 41 infants showed normal development; 16 presented with mild neurological abnormalities; and 4 developed cerebral palsy. Key EEG features-such as maturational patterns, sleep states, interburst interval, burst morphology and DS at 6 h of life-were highly predictive of outcomes. Correlations were also observed for sleep states, burst morphology, and DS at 12 and 24 h. Notably, burst amplitude and seizure did not correlate with outcome. Additionally, EEG recovery-observed in all patients-was temporarily impaired by seizures in 18% of the cooled infants. Conclusions: The EEG findings within the first 6 h of life were the most predictive of neurodevelopmental outcomes. The DS and EEG maturational features emerged as the most robust indicators of prognosis.