Distance Learning in Paediatric Neurology
BPNA

Unit 2: Neonatal Neurology & Embryology

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Update

Unit 2 is currently being revised and updated. The updated unit will be available shortly.

Overview

We will be studying the biological processes involved in brain development and then go on to see how environmental and genetic disorders may have an adverse effect on that process. We will study perinatal brain injury and causes of this in both the preterm and the term born baby. We will study neonatal encephalopathy, and we will learn about assessment, differential diagnosis and treatment options in the floppy and “stiff” baby. The unit will also address different aspects of neonatal neurological examination, neurophysiology, and neonatal imaging and how this benefits initial assessment and relates to prognosis. Throughout the Unit we will reflect on how we might most effectively communicate our thoughts to the families involved.

Programme 

This Unit contains 48 hours of study, divided into the following sections:

  Study hours

1. Development of the nervous system
Aim:  This section will provide a synopsis of the main processes and phases of brain development. Material will be provided that will develop understanding of the mechanisms involved in gene expression and subsequent neuronal migration. We will look at the part intercellular signalling and gene expression play in the movement and targeting of neurones during migration; and how inter-neural signalling and apoptosis shapes brain structure and ultimately function. Now, on the face of it you may find this list rather dry and off-putting. Do not panic! The journey we shall take together through the complex process of brain development is both awe-inspiring and exciting. On the one hand it will allow us to understand more about how the process may go wrong, and on the other hand the new-found knowledge will help us counsel the families involved.

6 hours

2. Abnormal cerebral, cerebellar and spinal cord development and neurogenetics
Aim: To understand the mechanisms of embryonic brain injury, cerebral and cerebellar malformation and dysplasias.

9 hours

3. Fetal neurology
Aim: The aim of this section is to develop an approach to understand common fetal malformations, update oneself with latest evidence, common questions asked by parenst during fetal condition and to share available knowledge about the neurodevelopmental outcome.

6 hours

4. Preterm brain injury
Aim: In this section we shall study an over view of the development of cerebral vasculature. We shall see how developing blood vessels relate to glial cells and introduce ourselves to the concept of the neurovascular unit. We will study the role of glial cells and the part they play in immunity and myelination. We shall then study some disorders of myelination including PVL.

4 hours

5. Perinatal stroke and intracranial haemorrhage in the term baby
Aim: To review the current understanding of the mechanisms and epidemiology of cranial haemorrhage, sino-venous thrombosis and foetal stroke, with their pathological and clinical consequences in term infants.

6 hours

6. Neonatal encephalopathy
Aim: This section will familiarise you with the obstetric antecedents and clinical features of HIE, along with the principles of investigation and management, including an overview on therapeutic hypothermia. We will discuss how to assess prognosis based on severity of injury deduced from clinical observation and principles of investigations including neurophysiology and neuroimaging. Consider the differential diagnoses of neonatal encephalopathy to include neonatal hypoglycaemia and hyperbilirubinaemia, as neurological injuries.

4 hours

7. Neonatal seizures and neonatal EEG
Aim: By the end of this section you will have acquired a good working knowledge of the clinical presentation of neonatal seizures and epilepsy syndromes, as well as their causes, differential diagnosis and management. You should be able to understand the principals of neonatal EEG and CFM and their role in the diagnosis and management of neonatal seizures.

4 hours

8. Floppy baby, stiff baby
aim: To understand the anatomical sites and aetiologies of conditions that affect tone in a newborn infant. We discuss pathologies that may lead to neonatal hypotonia and hypertonia, as well as the investigative approach.

4 hours

9. Neurological examination of the preterm and full term infant
Aim: In this section we aim to look at the role of a standardised neurological examination as one of the basic steps in the work-up of neurological problems in the newborn, including the differentiation between central nervous system and peripheral nervous system disorders. We will also explore the scope of the neonatal neurological examination in predicting future neurodevelopmental outcome.

2 hours
10. Imaging in the neonatal period 3 hours
Total study hours = 48 hours

 

The next start date for this unit is December 2014. You can work through it at your own pace, there are no time limits to finish. If you spend about 4 hours per week on this course, you will complete it in 3 months. When you complete the unit, please send it to us. On receipt of the completed unit, we will check that all 3 star activities have been completed and will issue a CPD certificate for the number of hours shown above.

Who is this Unit for?

The Neonatal Neurology & Embryology Unit is particularly suitable for:

  • Junior paediatric trainees on rotation in the neonatal department
  • Specialist Paediatric trainees
  • Specialist Neonatal trainees
  • Specialist Paediatric Neurology trainees
  • Consultant Paediatricians who provide neonatology services in district general hospitals
  • Consultant Neonatologists to update themselves as part of their continuing professional development
  • Consultant Paediatric Neurologists to update themselves as part of their continuing professional development
  • Those who have completed the BPNA 2-day NeoNATE course and wish to learn more

Resources

We will provide all the papers required to complete this Unit. 

What do students say are the best things about this unit?

  • “Understanding glia! And the section on neonatal tone assessment” (UK)
  • “Very relevant to day to day clinical practice, especially for me as currently in neonates. Better understanding of the pathophysiology of PVL, neonatal stroke, seizures and their management” (UK)
  • “Fetal and neonatal hydrocephalus” (Georgia)
  • “Neonatal EEG, neuroembryology, hydrocephalus” (Saudi Arabia)
  • “The ease of reading, helpful commentaries” (UK)

Register

Fees must be paid at the time of registering. You can register online and pay your fee by credit/debit card or request an invoice be sent to your place of work (you will need a purchase order number from your hospital for this option). The cost of this Unit depends on the country in which you are working.  

  • High income countries = £325 (eg Western Europe, Australia, North America, Gulf States)
  • Low & middle income countries = £107

 

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