Advice

The technology

The technology

The Neon EEG (Incereb) is a device which fits over the scalp of a newborn, like a cap. The device contains a passive electrode array for the purpose of recording an EEG when connected to a suitable recording system.

The Neon EEG needs a compatible EEG multichannel recorder and is available as an 8- or 12-lead option. Each single-use device is individually packaged with all 8 or 12 leads contained in a single ribbon cable. The cable has touch-proof, labelled connectors for universal connectivity, or a D-type electrode cap connector, which is designed for ease of connection in a single movement to the multichannel recorder.

The company claims that when the Neon EEG is applied to the scalp, which takes about 2 to 3 minutes, the electrodes are automatically positioned symmetrically. It is designed to be in accordance with the international 10 to 20 placement system.

Innovations

Neon EEG differs from current electrodes used for multichannel EEG recording in newborns. It is designed to be applied, after minimal training, by any member of neonatal clinical staff with minimal training and without needing an EEG technician.

Current care pathway

EEG is used if there is a risk of a newborn having seizures, for example if there has been a lack of oxygen to the brain during delivery. Newborns born between 32 weeks gestation and term, and aged up to 9 weeks post expected due date, at risk of seizures or hypoxic-ischaemic encephalopathy would have an EEG done typically in a neonatal intensive care unit (NICU). Current options for recording neonatal EEG are:

  • Multichannel EEG: A trained EEG technician places the adhesive electrodes on the scalp for multichannel EEG monitoring. This is considered to be the gold standard of neuromonitoring, but may not be indicated, or available. Specialist commentators have suggested that most babies will only need routine EEG monitoring (single or dual channel amplitude integrated EEG monitoring).

  • Single or dual channel amplitude integrated EEG (aEEG): A non-EEG expert such as a neonatal nurse or a neonatologist can record single or dual channel EEG using 3 to 5 adhesive or invasive subdermal needle electrodes. The output from aEEG needs less interpretation but is less informative than the multichannel gold standard. Specialist commentators have stated that this is the most widely used method in the NHS.

Population, setting and intended user

This device would be used in the NICU by neonatologists and neonatal nurses on babies at risk of seizures or hypoxic-ischaemic encephalopathy. Newborns with mild to severe oxygen deprivation during delivery, or those with underlying neurological, metabolic or vascular disease will have an increased the risk of neonatal seizures needing monitoring by EEG. Some seizures are sub clinical and therefore not witnessed, and are only detected on multichannel EEG monitoring.

The Neon EEG device is designed to be used by non-expert EEG users after minimal training, which is provided by the company in a short instructional video.

Costs

Technology costs

The Neon EEG devices (Neon8 and Neon12) are supplied in individual sealed plastic trays complete with skin preparation gel at a cost of £50 to £60. The devices use standard 1.5 mm touch proof or D-type connectors (not supplied) to attach to existing compatible multichannel EEG recorders.

Costs of standard care

Single or dual channel amplitude integrated (aEEG) monitoring is usually done by a trained doctor or nurse and can take between 5 minutes (needle electrodes) and 30 minutes (gel electrodes) to fit the electrodes. The cost of standard care is expected to be around £30 for a gel electrode and adapter set or around £35 for needle electrodes, not including clinician time.

Resource consequences

Neon EEG would be an additional cost compared with standard care. Other than the need for a compatible multichannel recorder, there are no infrastructure or practical barriers to using the Neon EEG device. The device is suited to doing EEG recordings out of hours, when a trained EEG technician is not available.

The device is not currently used in the NHS.