Seizures in babies: could a new imaging technique improve diagnosis?

Over 2,000 newborn babies born at full term suffer seizures each year in the UK.¹ Early diagnosis and treatment are vital, as seizures may cause lasting brain damage. However, seizures sometimes go unnoticed, as babies can have no obvious symptoms. Dr Topun Austin, of The Rosie Hospital, Cambridge, is investigating whether a cutting-edge new technique – which combines imaging the brain with monitoring of its electrical activity – might improve diagnosis and allow more babies to benefit from early treatment.

What is the problem and who does it affect?

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

‘Seizures remain a major challenge when caring for newborn babies,’ explains Dr Austin. ‘They result from abnormal bursts of electrical activity in the brain, but can be difficult to diagnose, as babies do not necessarily have any obvious symptoms. Abnormal movements may be subtle or not even present.’

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.’

‘Treatment of seizures in newborn babies also remains difficult,’ continues Dr Austin. ‘Although drugs may suppress abnormal movements, they don’t always stop abnormal brain activity.’

Evidence suggests that on-going seizure activity can damage the brain. Better diagnosis and treatment of seizures are urgently needed.

What is the project trying to achieve?

Dr Austin is developing a new way to diagnose seizures, which combines existing EEG technology with a new optical imaging system.

‘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. The optical 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 and improve diagnosis. ‘The ultimate aim is to develop the new system for routine use at the cot-side,’ explains Dr Austin. ‘We believe this could lead to better treatment of vulnerable babies, which could boost their chances in life.’

The new technique could also help other people with seizures or epilepsy.

What are the researchers’ credentials?

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.

References

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. http://www.ncbi.nlm.nih.gov/books/NBK2599/
3. Davis AS et al. Seizures in extremely low birth weight infants are associated with adverse outcome. J Pediatr 2010; 157: 720-5.