Predicting seizures in babies
Ireland has a unique opportunity to capitalise on its high birth rate and its different strands of research in the perinatal field, writes CLAIRE O'CONNELL
WHEN PROF Geraldine Boylan was expecting her third child, it suddenly struck her that she had made the right move in her work. She was walking around the neonatal intensive care unit at a London hospital, where she was starting a PhD on brainwaves in tiny babies to measure seizures.
“Every day when I was working in the neonatal intensive care unit I realised that while it’s a small minority of children who end up there, it’s not a small minority when it is your child, it’s major,” she recalls.
Boylan, a scientist, had just moved from a clinical neurophysiology job into research with the aim of monitoring what is going on in the brain of a newborn when they are very sick in intensive care – though she is quick to point out that just because a baby is in intensive care does not mean they will have neurological problems.
“A lot of babies in intensive care do fantastically well and they go home and there are no problems,” she says. “We concentrate on a very specific group of babies who have been identified as being at risk of brain injury. They have had problems early on, maybe a lack of oxygen or blood supply to the brain around the time of birth and some of these babies go on to have seizures or ‘fits’.”
Prolonged seizures can be damaging, yet it’s not always obvious from just looking at the baby that one is happening. One way to find out is to monitor the brain using EEG technology. So, in her PhD at King’s College London she decided to use EEG to identify which babies needed help.
“To be honest, moving to research was the best thing I ever did. I always wanted to do something in science that made a difference and I saw this was something I could do,” she says.
“I hoped that by identifying problems earlier that we could help these children get the intervention they needed faster and that in the long term this would improve their outcome.”
Initially the equipment she had to use in the ward was huge, and neonatal units can be quite tight for space. “Back in the 1990s the machines we had were big devices, so it was difficult to do studies of brain monitoring in babies,” says Boylan.
“But we did it because we realised that some babies were having neurological problems. It struck me that in intensive care we were monitoring signals such as heart rate, breathing and blood pressure, but nobody was looking at the brain. So we did some of the first studies of continuous brain monitoring in newborns, and realised just how many seizures a number of these very sick babies were having.”