Pune: Baby with A Complex Neurological Disorder Successfully Treated at Hospital In Lulla Nagar

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Pune, 17th May 2023: A team led by Dr Vrushali Bichkar, Consultant Paediatrician and Neonatologist, Motherhood Hospital, Lullanagar, Pune adopted a multi-disciplinary approach to successfully treat a baby with a complex neurological disorder causing convulsions. The baby was known to have a condition called “neonatal encephalopathy”, meningitis with hypoplasia of corpus callosum.

Mrs Nirmala Devi (name changed) and her husband are residents of Haveli, a taluka of Pune district in Maharashtra. They were elated after the birth of their baby boy. It was a term baby weighing 3.4 kgs and had a delayed crying at birth. Baby had convulsions/seizures/fits starting at 28 hours of life along with lethargy.The baby was referred to Motherhood Hospitals, Lullanagar, wherein he needed NICU care & support.

Dr Vrushali Bichkar, Consultant Paediatrician and Neonatologist, Motherhood Hospital, Lullanagar, Pune said, “Baby was lethargic and had episodes of convulsions or epileptic seizures on arrival to the hospital which required multiple anticonvulsants medication to control it. While the EEG test showed suggestive disturbed neurological function, also called neonatal encephalopathy. A team of doctors including a neurologist and geneticist were involved. Inborn error of metabolism was ruled out. CSF was performed which suggested partially treated meningitis (a bacterial or viral infection of the fluid surrounding the brain and spinal cord usually causes the swelling). In view of intermittent brief episodes of seizures, MRI was performed which suggested hypoplasia of corpus callosum which is a rare brain defect affecting 0.05 to 0.07% of the population.”

In this condition of the corpus callosum, a bundle of nerves connecting the left and the right side of the brain is partially missing. Symptoms range from minor intelligence issues to developmental delays and seizures. Causes for this condition include genetic inheritance, foetal alcohol syndrome or injury or infection during the second trimester of pregnancy. Treatment for an absent corpus callosum depends on how the disorder affects an individual. It often includes genetic counselling, physiotherapy, and occupational therapy to minimize developmental delay, speech therapy or special education to address intellectual issues. Parents continued treatment after the baby was discharged from the hospital, after 3 weeks.

Neonatal seizures or neonatal convulsions are epileptic fits occurring from birth to the end of the neonatal period. The neonatal period is the most vulnerable of all periods of life for developing seizures, particularly in the first 1–2 days to the first week from birth. It could be life threatening if not treated at the right time. Further follow ups are needed for such NICU graduates for monitoring of their growth and development.

We were dealing with a complex case which required multidisciplinary approach, constant monitoring and series of investigations which could have been financially draining. Neonates’ foundation of India turned out to be a big support system in this case, added Dr Bichkar.

And NICU care provides highly advanced technology and care to the babies with birth defects and there is an exorbitant cost associated with it. Having a meagre income, the baby’s father was afraid of how to cover the cost of his son’s NICU stay. Motherhood Hospitals being one of the partners, immediately got in touch with the Neonates Foundation of India, to support the parents for raising funds for their new-born son. The NICU support gave a new lease of hope for the baby.

“We were anxious and scared after looking at the condition of our new-born. Our happiness turned into a nightmare as we were told about multiple complications our baby was going through. He was detected with issues, which is not known to us. We thank the team of doctors and Neonates Foundation of India, who provided ample support to our baby and gave him a new lease of life,” concluded Mrs Nirmala (name changed), mother of the baby.