Observations from the SickKids Centre for Brain and Behaviour Conference
SickKids Centre for Brain & Behaviour 2nd Biennial Conference
– Brain Injury in Children
July 12 – 14, 2011 – Toronto, Canada
Day one of the conference was dedicated to a review of issues relating to birth injury and neonatal encephalopathy. We had some excellent speakers involved in leading edge research in this area, many of whom suggest that there is hope for families of babies who will be born with birth asphyxia. New research is showing that treatments like hypothermia, if provided quickly following neonatal injury, reduces neuro-developmental disability in survivors of encephalopathy. The bad news is many hospitals in Canada are still not using hypothermia despite numerous studies showing its effectiveness in decreasing infant deaths and the progression of injuries.
There is continuing controversy around what will be included in the new definitions of encephalopathy – the present ACOG and AAP standards require that an infant suffer from cerebral palsy before that baby will be included. Neuro-imaging is crucial to determine the type of injury and the timing of the injury and will be vital when we try to prove that an infant’s injury occurred during labour and was preventable. Seizures are an ongoing problem. Research has shown that most of the babies with seizures are not recognised as having seizures because they are happening “sub-clinically” and not observable. Those babies still need treatment so that these seizures do not cause further injury. Careful monitoring with EEG’s is required for all babies who are at serious risk of seizures. Visual observation can miss as many as 90 percent of all seizures!