Researchers at University College Cork are working on the development of an automated seizure detection system in new-born babies with the aim of preventing brain damage and, in severe cases, death.
The research is of particular importance because seizures are more common in the neonatal period than during any other time throughout life. Premature babies have a much higher incidence of seizures than babies born at full term.
Brain injury in newborn babies, sometimes caused by a lack of oxygen around the time of birth, can result in cerebral palsy, mental retardation, learning disabilities and epilepsy. In Ireland, about 300 babies a year are affected by significant brain injury and, in approximately 50 babies, this injury results in death or severe disability.
A multidisciplinary team of clinicians, scientists and engineers from the departments of paediatrics and child health and electronic and electrical engineering at UCC are using EEG (measurements of electrical brain activity) and other physiological measurements to investigate brain injury and seizures in newborn babies.
The research work, led by UCC paediatrics lecturer Dr Geraldine Boylan, creates a synergy between medicine and engineering by using the skills and techniques of engineering signal processing research to address important medical problems such as automated seizure detection in newborn babies.
Although sick newborn babies in neonatal intensive care units already have continuous monitoring of many physiological variables including heart rate, respiration, oxygenation and blood pressure, Dr Boylan points out that brain activity is rarely monitored.
She is concerned about the failure to detect newborn seizures which can, if untreated, lead to brain damage, even death. Seizures are often undetected because babies do not exhibit obvious clinical change during the seizures. The only accurate technique available for diagnosing all seizures in babies is EEG, which records electrical brain activity using small electrodes placed on the scalp. EEG equipment is expensive and requires highly specialised technical and medical personnel to acquire and interpret the results.
"Most neonatal units in Europe lack this expertise and have to rely on clinical judgment alone to diagnose seizures, which is known to be inaccurate. It is therefore imperative that a seizure detection system that is simple to operate, easy to interpret, and that provides reliable accurate information is developed," Dr Boylan stressed.
The UCC research team has established that the EEG is the most sensitive technique available for seizure detection in newborn babies. They now aim to develop a signal processing system that will help medical staff identify all seizures in newborn babies without the need for complicated equipment or an expert to interpret the results.
A unique set of prolonged multimodal recordings have already been collected from more than 70 newborn babies in the neonatal intensive care units in Cork for further analysis.
"Early detection of seizures will allow prompt and effective treatment and should translate into better long-term neurological outcome for the smallest and most vulnerable members of the population," said Dr Boylan.
The director of the neonatal intensive care unit in Cork, Prof Anthony Ryan, said the advances in research and care in neonatology could be seen throughout the decades.
"Without question, the new millennium decade is the decade of the newborn brain. We can now save babies through respiratory, metabolic and nutritional enhancement, but can we improve the neurological outcomes of both premature and term newborns? Our neonatal research group believe we can," he said.
