Seizures In Babies: Cutting-Edge Imaging Technique To Improve Diagnosis

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Main Category: Pediatrics / Children's Health
Article Date: 03 Aug 2012 - 10:00 PDT Current ratings for:
Seizures In Babies: Cutting-Edge Imaging Technique To Improve Diagnosis

A cutting-edge technique, combining brain imaging and monitoring of its electrical activity, could improve early diagnosis and treatment of babies who suffer seizures.

Researchers at The Rosie Hospital, Cambridge, are investigating the new technique with funding from children's charity Action Medical Research.

In the UK over 2,000 newborn babies suffer seizures each year.1 Early diagnosis and treatment is vital, as seizures may cause lasting brain damage. However, seizures sometimes go unnoticed, as babies can have no obvious symptoms.

Dr Topun Austin at The Rosie Hospital was awarded £131,150 by Action Medical Research for the two year project. "Seizures remain a major challenge when caring for newborn babies," explains Dr Austin, "but can be difficult to diagnose as abnormal movements of the baby may be subtle or not even present."

Around two or three babies in every 1,000 born alive also suffer from seizures within a month of birth.2,3 Babies born very prematurely are especially vulnerable, as are babies who suffer from a lack of oxygen during birth.

Babies who are suspected of suffering from seizures are normally referred for specialist tests. "The current diagnostic test is an electroencephalogram (EEG), which measures electrical activity within the brain," explains Dr Austin. "EEG has limitations though, as it can only detect seizures occurring near the surface of the brain. It cannot detect abnormalities deeper within the brain."

Dr Austin is developing a new way to diagnose seizures, which combines existing EEG technology with a new optical imaging system. The technique could also help other people with seizures or epilepsy.

"When babies have a seizure, there is a large amount of electrical activity in the brain, which we are measuring with EEG," explains Dr Austin. "The amount of oxygen in the brain also changes, which we are measuring with the new optical system. This system works by shining near-infrared light into the brain, which is harmless and non-invasive."

Dr Austin hopes the new combined technique will boost understanding of what's happening inside the brain during seizures: "The ultimate aim is to develop the new system for routine use at the cot-side."

This project brings together a team of clinicians and scientists with a proven track record in developing new technologies to study the infant brain. Most of the work is being carried out in a new neonatal unit - one of the largest in the country - at the Rosie Maternity Hospital, Cambridge.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
Visit our pediatrics / children's health section for the latest news on this subject. 1. Rennie JM, Hagmann CF, Robertson NJ. Neonatal cerebral investigation. (2008) Cambridge University Press.

2. Panayiotopoulos CP. Chapter 5. Neonatal seizures and neonatal syndromes. The Epilepsies: Seizures, Syndromes and Management. Bladon Medical Publishing (Oxfordshire UK) 2005.

3. Davis AS et al. Seizures in extremely low birth weight infants are associated with adverse outcome. J Pediatr 2010; 157: 720-5.

Source: Action Medical Research

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1 In 50 Babies Has Birth Defect: Report Highlights Worrying Gaps In Regional Monitoring

Main Category: Pediatrics / Children's Health
Also Included In: Heart Disease;  Neurology / Neuroscience;  Pregnancy / Obstetrics
Article Date: 15 Dec 2011 - 0:00 PST

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More than one baby in every 50 is born with a birth defect (congenital anomaly) according to the latest annual report by the British Isles Network of Congenital Anomaly Registers (BINOCAR) - significantly more common than previously reported estimates of around one in 80.

The study* - led by researchers at Queen Mary, University of London and commissioned by the Healthcare Quality Improvement Partnership (HQIP) - is the most up-to-date and comprehensive of its kind, bringing together existing data in England and Wales from 2005 to 2009.

However, the report's authors remain concerned that data for substantial parts of the country, including London, are not currently monitored, meaning large regional increases in birth defects could go unnoticed and their causes not investigated.

"This is a major issue," commented Joan Morris, Professor of Medical Statistics at Queen Mary, University of London and editor of the report. "It is essential we know how many babies are being born with anomalies and how good their survival is across the whole country, so we can identify ways to reduce the occurrence of anomalies and plan for the care of these babies."

This national report includes data from five regional registers and two disease specific national registers†. Three additional registers exist and it is hoped that with further funding they will contribute data to future reports. Currently there are no registers in London and the South East, the North West and East Anglia.

Professor Elizabeth Draper from the University of Leicester who is Chair of BINOCAR commented: "This report is important, not least because it highlights the need to increase the number of regional registers in England. We are very grateful for the ongoing support from HQIP, but to provide national coverage will require a sustained commitment of additional resources. Funding for national surveillance of congenital anomalies is being considered as part of the surveillance program in Public Health England and we hope it will be in place by April 2013."

The number and types of birth defects have been monitored since the thalidomide epidemic in the 1960s. Under the original system, cases were notified to the Office for National Statistics by doctors, nurses, midwives and health visitors. Since the 1980s, regional registers have been established in some parts of the country to actively collect data from hospitals, laboratories and health records.

In the intervening years, lack of strategic funding coupled with a lack of support at national level has led to the closure of the national system and some of the regional registers. This report collates data from five regional registers, which together cover 28 per cent of the population of England and Wales, leaving the vast majority of birth defects unreported. Previous estimates, based on data from the Office for National Statistics, suggested that 1.3 per cent of babies have a birth defect. The new report indicates that the figure is more than two per cent. The researchers estimate that there were at least 14,500 babies born with birth defects in England and Wales in 2009. The most common defect was congenital heart disease, which affects at least five in 1,000 births. Some cases require major operations and around six per cent of babies born with a heart defect will die before the age of one. Neural tube defects, such as spina bifida, affect one in 1,000 babies, many of these may be prevented by women taking folic acid supplements before becoming pregnant. Gastroschisis - a defect where the intestines develop outside the abdomen - affect one in 1,000 babies. Regional monitoring has shown that this condition has become more common in some areas including Wales and that babies born to younger mothers are at greater risk. Over half of all major birth defects were detected during pregnancy. Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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Few Allergies In Unstressed Babies

Main Category: Anxiety / Stress
Also Included In: Allergy
Article Date: 13 Dec 2011 - 0:00 PST

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A new study from the Swedish medical university Karolinska Institutet shows that infants with low concentrations of the stress-related hormone cortisol in their saliva develop fewer allergies than other infants. Hopefully this new knowledge will be useful in future allergy prevention. The study is published in the December paper issue of Journal of Allergy and Clinical Immunology.

The incidence of allergies in children has increased over the past few decades, especially in the West. In Sweden, 30 to 40 percent of children have some kind of allergy. A combination of environmental and lifestyle factors during pregnancy and early infancy are thought to be responsible for the sharp rise in allergic diseases.

"Psychosocial factors and the stress hormone cortisol are associated with allergic diseases," says Dr Fredrik Stenius of the Department of Clinical Research and Education at Stockholm South General Hospital. "Our study found that children with low salivary cortisol levels as infants have a lower prevalence of allergies during the first two years of life, compared to other children."

The team has previously described a link between a lower prevalence of allergies in school children and an anthroposophic lifestyle.

"And now we've found the same link in infants from families that follow anthroposophic lifestyles, and that they have relatively low levels of cortisol," adds Dr Stenius, who earned his PhD earlier in the year with a thesis on the subject.

The researchers believe that factors related to stress regulation also influence the development of infant allergies and will now monitor the infants from the neonate period and into childhood.

Article adapted by Medical News Today from original press release. Source: Karolinska Institutet
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Premature Babies Harbor Fewer, But More Dangerous Microbe Types

Main Category: Pediatrics / Children's Health
Also Included In: Infectious Diseases / Bacteria / Viruses
Article Date: 11 Dec 2011 - 0:00 PST

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One of the most comprehensive studies to date of the microbes that are found in extremely low-birthweight infants found that hard-to-treat Candida fungus is often present, as well as some harmful bacteria and parasites.

Researchers at the Duke University Medical Center and Nicholas School of the Environment looked at the microbes in 11 premature infants and found much less diversity than in full-term infants.

"The babies' guts were taken over by microbes we know are dangerous if they get into the blood," said senior author Patrick Seed, M.D., Ph.D., assistant professor of pediatrics at Duke. "Even after the babies were no longer on antibiotics, healthier bacteria didn't appear in the babies very quickly. This may be one reason why premature babies are so vulnerable to infections."

All of the premature children were placed on antibiotic treatments after birth, which would wipe out some types of bacteria and yeast, but once they were off the antibiotics and taking food, the researchers expected to see more diversity of bacteria in the babies' developing digestive systems than they found.

The findings were published in PLoS One open-access journal on Dec. 8.

Five infants had blood infections while three had necrotizing enterocolitis, an infection-related death of bowel tissue, said Seed, who is also with the Jean and George Brumley Jr. Neonatal-Perinatal Research Institute and the Duke Center for Microbial Pathogenesis.

Seed said that while the study babies mainly were colonized mainly by organisms that were found in stool specimens, in some cases they also had infections with Staphylococcus epidermidis, a form of staph infection, that was abundant in many of the babies' digestive tracts.

The bacteria and yeast in the premature babies' digestive tracts are known causes of devastating infections in these babies. The gut seems to be a reservoir for some organisms that form infections, Seed said. Previous to this work, "we only knew the tip of the iceberg," he said.

The researchers used genomic (DNA) typing of the bacteria, fungi and parasites to determine which types were present.

It's not clear if the newborns are picking up these early infections from their mother's milk, blood, or in other ways, or if the pathogens are from the environment surrounding the infants.

"It's important to know where these pathogens come from so that doctors can possibly manipulate the babies' environment or their digestive systems," Seed said. He noted that other studies had shown value for giving babies probiotic substances to tip the internal balance toward more favorable bacteria, necessary for immunity and better health.

Seed stressed that certain bacteria and other microbes are helpful for growing babies and their immune systems, so it is important not to do any damage by creating an antiseptic environment.

"It's a question of balance," Seed said. "As vulnerable as these babies are, we still wouldn't want to wipe out all of the bacteria, even all of the potentially harmful bacteria."

Other authors include Mariam LaTuga, Michael Cotton, Ronald Goldberg and James Wynn of Duke Department of Pediatrics; and Christopher Ellis and Robert Jackson of Duke's Nicholas School of the Environment (Jackson is also with the Biology Department and the Center on Global Change at Duke University). Several co-authors also are with the Jean and George Brumley Jr. Neonatal-Perinatal Research Institute.

This research was supported by a pilot grant from the Duke Institute for Genome Sciences & Policy, the Duke Department of Pediatrics -- Division of Perinatal-Neonatal Medicine, the Jean and George Brumley, Jr. Neonatal-Perinatal Research Network and the Center on Global Change, as well as support from the Gerber and Hartwell Foundations.

Article adapted by Medical News Today from original press release. Click 'references' tab above for source.
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