A KEY part of tackling any health problem is being able to diagnose it properly. But when it comes to brain seizures in newborns, that's often easier said than done.
Seizures are more likely in the first 28 days of life than at any other time, according to Dr Seán Connolly, a consultant neurophysiologist at St Vincent's University Hospital in Dublin.
He was a lead investigator on a two-year project to improve the diagnosis of brain seizures in newborns at Cork University Maternity Hospital, which screened 70 babies at risk of seizures.
"In many cases, a seizure reflects an injury to the brain," he says. "And the identification of seizures in this group is important because it's known that subsequent cognitive and physical disability can result from these seizures, particularly prolonged neonatal seizures. So we want to be able to identify these accurately and to treat them."
But therein lies the difficulty, because in newborns there may be few outward signs that anything untoward is happening in the brain, notes Connolly.
"In many cases, there are movements and behaviours that can be thought to be seizures and are treated, and putting the infant on this medication when they don't need it is not a good thing," he says. "On the other hand, the infant may have seizures which we can detect on the EEG but they have very little clinical manifestation, so they go undetected."
That's why a team of researchers led by Dr Geraldine Boylan from University College Cork asked parents for consent to fit non-invasive electrodes to the scalps of babies in the intensive care unit at CUMH. By recording the brain waves, or EEG readings, and simultaneous video footage of the babies, they built up a large database of information to help identify seizure events. Connolly analysed the EEG readouts - some of which lasted up to 66 hours - and identified signatures that indicated a brain seizure.
One of the goals is to develop an automated monitoring system that can sit by the cot and alert nursing and medical staff when a seizure happens. So engineers at UCC and UCD have been analysing the data from the Cork babies to move that forward, explains Connolly.
"It's technically very challenging to do these recordings and most neonatal intensive care units don't have that expertise," he says.
"So it would be a really great addition for the neonatologists to have a tool that could reliably indicate to them when a neonate is having one of these seizures, and also a tool to be able to ask the question was that a seizure or not."