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About Sickkids
About SickKids

August 1, 2010

Brain work

Image of Carter Snead

SickKids' Centre for Brain & Behaviour has developed one of the world’s leading paediatric epilepsy surgery programs and set a gold standard for centres of excellence.

Children with epilepsy are as smart, athletic, funny and inquisitive as other children, except their brain produces too many electrical impulses that cause seizures.

Treatments are available, including anti-convulsant medication, a special diet, and a device that stimulates certain nerves in the brain. Thousands of children have benefitted from such treatments and have grown up without the disruptions, social stigma and physical stress of seizures.

However, about one-third of children with epilepsy don’t respond to these solutions. For surgical help, they may well look to SickKids' Centre for Brain & Behaviour.

SickKids offers the best surgical solution to epilepsy available anywhere, says Dr. Carter Snead, Director of the Centre for Brain & Behaviour. A distinguished neurologist, he moved from Children’s Hospital Los Angeles to Toronto in 1996 to assume the position as Head of the Division of Neurology at SickKids. He is also Senior Scientist, Neurosciences & Mental Health, at SickKids Research Institute, and Professor in the Departments of Medicine, Paediatrics and Pharmacology at the University of Toronto. In addition, he holds the Chair in Paediatric Neuroscience at Holland Bloorview Kids Rehabilitation Hospital.

It takes months of tests to determine if an epilepsy patient qualifies for surgery. Due to the intensity of the process and the surgery itself, Snead’s team can operate on no more than two epilepsy patients a month.

One of the most innovative steps in the process is called invasive monitoring. During this procedure the brain is exposed and covered with a sheath of material that is dotted with electrodes. The electrodes show exactly where the higher-than-normal electrical impulses happen, which is the spot where the subsequent surgery takes place.

Despite losing a small part of their brain, epilepsy patients at SickKids emerge from surgery with few, if any side-effects. The success is not only due to the high-quality surgery, says Snead. Credit goes to the whole team whose extensive knowledge and expertise characterize the way things are done at the Centre for Brain & Behaviour.

The centre was established in 2007. A leader in integration, it brings together specialists in neurology, neurosurgery, neuroradiology, neuropsychology, psychiatry, social work, physical therapy, occupational therapy, neuropathology, neurosciences and mental health, nursing, neuroimaging research, critical care medicine, ophthalmology, and otolaryngology.

 “We are very proud of our program,” says Snead. “The centre has potential for enormous impact because of the multi-disciplinary work we do. The brain is the most complex part of the body; understanding the brain requires research from a large number of disciplines. Our centre has brought together disciplines that used to know little about each other, psychiatry and neurosurgery, for example, whose members in our centre are now exchanging ideas.”

The centre’s executive team includes: Dr. James Drake, Head of Neurosurgery, Elizabeth Ferguson, Child Health Services Director, Dr. Abel Ickowicz, Head of Psychiatry, Dr. Michael Salter, Head of Neurosciences & Mental Health at SickKids Research Institute, Snead, and Laurel Brown, Program Manager. As well as epilepsy, the centre investigates and treats childhood stroke, multiple sclerosis, headaches, neurometabolic disease, hydrocephalus and brain tumours.

Every month, the centre plays host to a popular one-hour seminar, Cross Talks, featuring a panel of speakers – these might include a scientist, a clinician or physician and a parent – who address the same topic from their particular point of view. The goal is to help attendees find common ground, to expand the intellectual horizons of health-care practitioners, and to help develop networks and collaborations that will lead to clinical breakthroughs. By attending Cross Talks, participants receive credits towards their continuing medical education, whether they are on site at SickKids or take part in the session electronically-transmitted to Holland Bloorview. This education model, also practiced by other SickKids centres, ensures that innovations and new ideas are shared, in keeping with SickKids’ strategic directions to create a culture of innovation and facilitate and promote the generation of new ideas.   

Last year the centre organized its first international symposium and the first international symposium of its kind, Brain Injury in Children, attracting delegates from 12 countries. The world’s leading neuro-specialists met for three days of medical education, discussing clinical, scientific and technological advances in their respective fields, contributing to enhancing child health and building capacity globally. The next symposium, scheduled to take place in Toronto next year, will anchor the centre’s reputation as an international leader and innovator in paediatric brain conditions.

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