Brigham and Women’s Hospital (BWH) has special expertise in neonatal neurology. This includes both a state-of-the-art clinical medical service and an academic program of research and teaching. Neonatal neurology refers to a service that can deliver multidisciplinary expertise aimed at optimal care and protection of the newborn brain—whether for premature infants or sick infants born at full term.
The clinical service is led by Mohamed El-Dib, MD, alongside a multidisciplinary team including neonatologists, specialized nurses, child neurologists, neuroradiologists, neurosurgeons and experts in neonatal electroencephalography (EEG). This service provides expert diagnosis, evaluation, management and counseling. Some of the clinical settings include:
Therapeutic hypothermia (cooling of the body temperature) for infants that need resuscitation at birth and may have suffered stress to the brain around birth
Specialized evaluation of brain injury in the premature infant
Monitoring of brain waves and brain blood flow in high-risk infants to detect seizures or alterations in brain blood flow
Monitoring and management of neonatal seizures
Evaluation and rehabilitation of neonatal stroke
Coordination of therapy services, such as physical, occupational and feeding services for high-risk infants at risk of brain injury
In addition, the BWH Department of Pediatric Newborn Medicine has many investigators working to systematically define the nature and timing of brain injury and altered brain development in the newborn period.
Magnetic resonance imaging is used with techniques including brain volumes, brain surface mapping, diffusion tracking of white matter fibers and resting state functional connectivity mapping. Brain monitoring techniques used include amplitude integrated EEG and near infrared spectroscopy. Nutritional analysis is undertaken with a human milk analyzer and a Pea Pod device. These studies include the influence of drug exposures, nutrition and therapy services on outcomes. The results of these studies will allow more targeted therapies for the right infant at the right time.
Finally, the evaluation of the outcomes of all of our high-risk infants from the newborn intensive care unit is critical to our mission to improve neurodevelopmental outcomes. Carmina Erdei, MD, and Jennifer Benjamin, MD, are directing an academic program aimed at systematic evaluation of the neurodevelopmental outcomes of our infants and relate this to any factors during their pregnancy, birth and neonatal care.