Doctors Corner

Report back ICNA 2018

Report back from the International Child Neurology Congress, Grand Hyatt, Mumbai
15-18th November 2018

Veena Kander Gill Riordan Sharika Raga Kirsty Donald Marie Wessels Jo Wilmshurst

Protecting the Developing Brain was the title of this year’s ICNA conference held in Mumbai, India. The conference was opened by the outgoing president, Prof Ingrid Tein. There was a minute of silence to honour the memory of Prof Linda de Meirleir, who made a huge contribution to knowledge of child neurology and to the ICNA. Professor Jo Wilmshurst from Red Cross War Memorial Children’s Hospital was welcomed as the incoming president of ICNA, a proudly South African moment! This is a brief overview of the talks given.

Thursday 15th November Plenary 1

Non infective Acute Encephalopathy – Prof Jacob John initiated the plenary sessions with a talk about a disease affecting undernourished children from rural North India. After much detective work it was discovered to be related to ingestion of seeds of the Cassia plant, as suspected by local health workers. Hepatomyoencephalopathy had initially been thought to be a form of viral encephalitis.

Plenary 2: Funny eye and head wiggles and other confusing ocular motor disorders in kids – David Zee

David Zee showed videos of different types of nystagmus, (see saw/windmill/convergence/pendular). He discussed mechanisms holding eyes still: a) vestibular (peripheral or central); b) gaze holding (brainstem and cerebellum); c) mechanisms that keep eye movements calibrated (maladaption and sensory deprivation (nystagmus of the blind)) and d) ion channels that control membrane stability (saccadic oscillations). Memantine can be used for congenital nystagmus.

Other interesting movements i) periodic alternating nystagmus – changes with direction of gaze due to a lesion in the cerebellar nodulus, treatment with Baclofen ii) figure of 8 head oscillations due to absence of cerebellar vermis. This was an excellent clinical learning session.

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