Monday, July 7, 2014

Pediatric Neurodiagnostics – A Very Special Skill

Most of the 25 years I spent in clinical neurophysiology, I spent specializing in working with pediatric patients.  I have a special passion for these young patients, and I have always found it especially fascinating to watch the development of the brain from premature infant to full term and the maturation of the EEG throughout childhood.  I had privilege of working at Children’s Hospital in Boston for 14 years, where I saw incredibly rare cases, and those with intractable seizures that became like family.
Where else can you observe such specific changes occurring every two weeks except in the maturing of EEG patterns in the neonate?  Delta brushes are so prominent at 32-33 weeks conceptional age and then abate rapidly.  Several patterns are very age specific and serve as an indicator of the age of the infant.

I also loved working with kids because you can get silly in the exam room.  You can sing silly songs, tell a story, and try to make them laugh.  I always had a small puppet peeping out from my lab coat pocket when I went to the waiting room to call for my patients.  I called the Omni Prep that we used to use to prep the skin “camel snot” because of the mucus textured base and sandy mix-in.
Last year we offered the first ever “Pediatric Neurodiagnostic” course track at the ASET 2013 annual conference.  It was very well attended and I am pleased that we can offer this track again this year.  We have assembled some really fantastic pediatric experts!  Since neonatal and pediatric EEG are included in the ABRET exams, if you do not have experience working with pedi patients, this will be an ideal opportunity to learn about this and help you prepare for the exam process!
Dr. Brad Ingram works with neurophysiology at the University of Mississippi Medical Center and he will be discussing Tuberous Sclerosis.  During my years at Children’s I saw so many patients with this disorder, mostly in the LTM unit.  He will discuss the disease in detail and treatments, including surgical resection of cortical lesions.
Dr. William Galentine is a pediatric epileptologist at Duke University.  He will be discussing the wide array of childhood epilepsies and encephalopathies.
Dr. Asim Shahid is coming to Asheville from the Cleveland Clinic, where he has a busy practice.  His presentation will explain the new guidelines published by the American Clinical Neurophysiology Society for continuous EEG in the Neonatal Intensive Care Unit.  He will include case studies to illustrate the practical application of these guidelines.

Susan Hollar is a technologist from Duke University, also dedicated to working with young patients.  She will follow with another presentation about EEG in the NICU, this on best practices for patient set-up and reducing the risk of stress and injury to these special, tiny patients.
Dr. Pestana Knight is a pediatric neurologist, also affiliated with the Cleveland Clinic.  She will present an overview of Infantile Spasms and the latest on diagnosis and treatment.
And Petra Davidson, a technologist working at the Mayo Clinic, will give a very helpful presentation with lots of tips on how to get a child through the process of diagnostic testing without sedation.
Please come to the ASET Annual Conference in Asheville. 

 The Pediatric NDT course will be on Thursday, Aug. 21.   Stop by and catch a couple of special pediatric presentations, they will all be very interesting and enlightening!

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