Neurological Disorders

Dear colleagaeus! I'm an Italian Child Neurologist with a special interest in newborn neurology and I work in strict collaboration with the regional NICU (Central Hospital of Bolzano). We are searching to stabilize an evidence-based protocol for the neuroimaging evaluation of newborns with HIE (with or without hypotermic treatment). Do You use a kind of protocol? Do You use MRi and MRS (of basal ganglia?) Wich timing of the evaluation do You advise? Thank You so much for Your answers! Sincerely Yours Marco Angriman

Hello for all: Anybody have a experience with use of levatiracetam in new borns and outcome to 18 months?

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Recently we had a newborn with intrauterine pneumonia having resistant seizures, apnoea and corneal edema following Intracranial bleed. We ventilated the baby, kept up fluid restricion,given anticonvulsants. Nothing worked until we started on anti edema treatment with mannitol and dexamethasone for 48 hrs. Baby impoved well, seizures controlled , recovered. Do you advocate mannitol in raised ICP ? Do you use dexamethasone? We have not used it till now. Give me your feedback and brickbats if any. dr.selvan Erode

This week we had 2 babies who have received 1 mg of vit.k in the neonatal period presenting with intracranial bleed. baby.1; 39 days old, B/o V mother anemic undernourished. Baby on exclusive breastfeeds.Baby had fever due to mastitis(skin laceration due to hook injury). Developed focal fits on LT side . Both PT & aPTT prolonged.platelets normal.CT shows bleed on RT side needed 2 anticonvulsants to control convulsions. Had blood transfusion for low Hb{8gms%}. Now baby is better. Feeding well. Any clues for the reason for the Intracranial bleed? Eventhough the baby received vit.K? selvan rathinasamy Erode, India

Is anyone using the Miniature Ommaya reservoir for treating hydrocephalus in neonates? How has your experience been?

A nice review A review of the current treatment methods for posthaemorrhagic hydrocephalus of infants. Shooman D, Portess H, Sparrow O. Cerebrospinal Fluid Res. 2009 Jan 30;6:1. LINK to Download

Hi Stefan, How are you? I would like to share your view regarding the use of Phenobarbital in Hyper-alert and irritable state with transient increase of tone and presence of rigidity in the first 24 hours of postnatal life [not to mention if clinically a case of Stage I HIE but where, there is no possibility of documentation to demonstrate the presence of any Electroencephalographic seizure]. Would also like to request you if possible for the citation of reference in this regard. Will be looking for your kind reply and further discussion. Best, Roy.

Dear Stefan, How are you? This is Roy again. I am putting the question in the open forum for discussion as you suggested regarding the use of adequate [?better] maintenance therapy for PHENOBARBITAL. Which I think is very essential for the use of this classical anti-convulsanat. I would like to know what recommendations will you [or our other forum members]suggest to follow regarding the management of neonatal seizures [chiefly Post asphyxial] if quality EEG facilities are not available? And how to withdraw the maintenance PHENOBARBITAL? My specific question is: I.How long should we continue the medication and how to omit in a set up with lim…

we have had 1 day old borne infant with clonic convulsions in betweens baby`s general conditions very good no inborn error`s detected .no hypoglycemia nor any electrolytes disorder`s also were detected could you please discuss the cause and inform us .thanks .dr hussam