Objective: To assess the time course of recovery of severely abnormal initial amplitude integrated electroencephalographic (aEEG) patterns (flat trace (FT), c ontinuous low voltage (CLV), or burst suppression (BS)) in full term asphyxiated neonates, in relation to other neurophysiological and neuroimaging findings and neurodevelopmental outcome. Methods: A total of 190 aEEGs of full term infants were reviewed. The neonates were admitted within 6 hours of birth to the neonata l intensive care unit because of perinatal asphyxia, and aEEG recording was star ted immediately. In all, 160 infants were included; 65 of these had an initial F T or CLV pattern and 25 an initial BS pattern. Neurodevelopmental outcome was as sessed using a full neurological examination and the Griffiths’mental developme ntal scale. Results: In the FT/CLV group, the background pattern recovered to co ntinuous normal voltage within 24 hours in six of the 65 infants (9%). All six infants survived the neonatal period; one had a severe disability, and five were normal at follow up. In the BS group, the background pattern improved to normal voltage in 12 of the 25 infants (48%) within 24 hours. Of these infants, one d ied, five survived withmoderate to severe disability, two with mild disability, and four were normal. The patients who did not recover within 24 hours either di ed in the neonatal period or survived with a severe disability. Conclusion: In t his study there was a small group of infants who presented with a severely abnor mal aEEG background pattern within six hours of birth, but who achieved recovery to a continuous normal background pattern within the first 24 hours. Sixty one percent of these infants survived without, or with a mild, disability. Objective: To assess the time course of recovery of severely abnormal initial amplitude integrated electroencephalographic (aEEG) patterns (flat trace (FT), c ontinuous low voltage (CLV), or burst suppression (BS)) in full term asphyxiated neonates, in relation to other neurophysiological and neuroimaging findings and neurodevelopmental outcome outcome. A total of 190 aEEGs of full term infants were reviewed. The neonates were admitted within 6 hours of birth to the neonata l intensive care unit because of perinatal asphyxia, and aEEG recording was star 65 of these had an initial FT or CLV pattern and 25 an initial BS pattern. Neurodevelopmental outcome was as sessed using a full neurological examination and the Griffiths’ mental developme ntal scale. Results: In the FT / CLV group, the background pattern recovered to co ntinuous normal voltage within 24 hours in six of the 65 infants (9%). All six infants survived the neonatal period; one had a severe disability, and five were normal at follow up. In the BS group, the background pattern improved to normal voltage in 12 of the 25 infants (48%) within 24 hours. Of these infants, one died, five survived withmoderate to severe disability, two with mild disability, and four were normal. The patients who did not recover within 24 hours either di ed in the neonatal period or survived with a severe disability. Conclusion: In t his study there was a small group of infants who presented with severely abnor mal a aEEG background pattern within six hours of birth, but who who recovered to a continuous normal background pattern within the first 24 hours. Sixty one percent of these infants survived without, or with a mild, disability.