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Dublin Conference for Professionals, October 2007

HemiHelp Trustee Liz Barnes reports on HemiHelp’s first Conference for Professionals in Ireland.

As part of our programme to reach more families, HemiHelp held a professional conference in Dublin on 25 October. We have always had members in both the Irish Republic and Northern Ireland, and at one time there was a separate HemiHelp NI, but this was our first conference in Ireland for medical professionals, and we were very pleased to have 60 therapists and paediatrians from both sides of the border attending.

Our chair for the day was Owen Hensey, Medical Director of the Central Remedial Clinic in Dublin. Founded to treatment children with a range of disabilities, the clinic decided to keep its doors open to patients into adulthood when it became clear that their needs didn’t disappear as they grew up.

Dr Owen Hensey: Changing Perspectives in Cerebral Palsy

Dr Hensey opened the conference with a talk called ‘Changing Perspectives in Cerebral Palsy’. I was shocked to hear that the official definition of CP still describes it only as a disorder of ‘movement and posture’. However a new proposed definition finally includes the other, less visible, problems that affect our children.

Owen Hensey went on to give us a plethora of facts and figures. In the developed world cerebral palsy, including hemiplegia, affects slightly over 2 per 1,000 babies born, and medical progress over the last decades has not changed this figure. The main reason for this is that more babies are falling into two high-risk groups. The first group, very premature babies, now have a much higher chance of survival, but 90 out of 1,000 children born at less than 28 weeks gestation develop some form of CP, and 50-60 of every 1,000 babies born at 28-31 weeks. These figures are in fact much lower than even twenty years ago, although Dr Hensey noted that the risk specifically of hemiplegia has not gone down, because haemorrhage, a common cause, is still less easy to treat than those types of trauma which tend to cause, say, diplegia. The second group of babies at increased risk, those in multiple pregnancies, has grown in recent years with the spread of IVF. On the plus side, acquired hemiplegia is now less common, thanks to improved treatment of infections, better management of epilepsy and the introduction of the Hib vaccine against meningitis.

Dr Steffen Berweck: Botulinum Toxin

Dr Hensey then talked about the various forms of treatment given to children with hemiplegia, including Botulinum toxin, the subject of the next presentation, by Dr Steffen Berweck from Munich. Dr Berweck spoke, as he had at our conference in Glasgow last autumn, about his use of ultrasound to ensure the best placement of Botox in the muscles, and his graphic video footage had me closing my eyes again. This approach is now beginning to spread in the UK – hospitals using it include Alder Hey in Liverpool and Guys and Great Ormond Street in London - so parents whose children have been recommended for this treatment should ask about its availability in their area.

Download Steffen Berweck's presentation (pdf format, 4MB)

Dr Peter Corry: Genetic factors in hemiplegia

After lunch Dr Peter Corry from Bradford, another veteran of our Glasgow conference, spoke again about how treating children from his local Pakistani community had thrown up new evidence of genetic factors in some cases of hemiplegia.

Amanda Connell: Physiotherapists and doctors working together

And the day was rounded off by two talks focusing on the advantages for children of doctors and therapists working together as an interdisciplinary team. When my son (now 21) was small I was irritated by the lack of coordination between his physio and OT. Today the advantages of team working are widely recognised in theory, but as Amanda Connell, a lecturer in Physiotherapy at the University of Limerick, admitted, lack of funds restrict its practice.

Dr Farhana Sharif: Involving parents more closely

However our last speaker, Dr Farhana Sharif, showed how an interdisciplinary approach can work even when money is short. Dr Sharif heads an early intervention team in Longford, in the Midlands of Ireland, and they were frustrated by their inability to monitor children regularly enough in this largely rural area. Their solution was to involve parents more closely, asking them to fill in regular detailed questionnaires on their child’s development, to help guide the team on how best to treat him or her. The scheme is a success, not only because parents know their children better than anyone else, but because they too gain more insight into how to help them develop.

It was altogether a very interesting and stimulating beginning to HemiHelp’s closer involvement in Ireland, and we hope to follow it up next year with a conference for parents.

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