Latest news in neurology 06 November 2018 (1 of 3)

Preliminary study suggests that a new skin sensor could help prevent life-threatening seizures for millions of people with hydrocephalus, a disease that causes fluid build-up in the brain.

When the disorder is diagnosed, a shunt is surgically inserted to drain the excess fluid – but the failure rate over 10 years for shunts is 98%, said the author Principal of the study, Siddharth Krishnan, PhD candidate at the McCormick School of Engineering at Northwestern University. "When they fail, there is no way to diagnose it quickly.The symptoms are not specific: headache and nausea."

Currently, the only way to diagnose a failure of the shunt is to perform a brain scan and sometimes even an operation. ] The risks of missing a shunt failure are enormous. "This can lead to coma, convulsions and possibly death," said Krishnan. "And the uncertainty that accompanies it can wreak havoc in the lives of families because they know that the next headache could be catastrophic."

In the small pilot study conducted on five patients, the researchers determined that the new wireless system, Band-Aid A form-shaped sensor could detect the difference between a patented shunt and another not, according to the published report October 31 online in Science Translational Medicine .

In other words, he could warn patients and doctors if the headache is a sign that the shunt has failed.

If the results are proven in a larger trial, the device could revolutionize the management of hydrocephalus, which could allow the US health care system to save millions of dollars, has said the senior author of the study, Siddharth Krishnan.

Approximately one million Americans have hydrocephalus and one in every 1,000 babies is born with this disease, according to the Hydrcephalus Association. In addition, it is often a complication related to premature birth.

The new device developed by Krishnan and his colleagues is equipped with a tiny heater in the center and a sensor at each end. It is placed on the skin where the shunt is located just below the surface. When the tiny heating element raises the temperature of a small area of ​​skin by a few degrees, it also heats the fluid inside the shunt at that location. If the shunt works, the sensors at both ends will detect the heat of the heated fluid as it descends.

Krishnan and his colleagues plan a much larger study – involving 100 patients – in the hope that the first results

The researchers made "a step forward in a long journey," said Dr. Shenandoah Robinson, professor in the pediatric neurosurgery division of Johns Hopkins Medicine. "Any progress is important, it would be interesting to be able to diagnose more easily a shunt dysfunction."

Robinson can imagine problems that may hinder the functioning of the device in some patients: obesity, for example. Nevertheless, she added, "It is possible that this may be useful for a small number of patients, and I think we will need validation studies to get a better idea" of the usefulness of this help.

– Linda Carroll