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Chinese

Clinical Sub-specialties
Neurology, Developmental Paediatrics and Neurohabilitation
(
兒童神經,發育及神經康復科)

Neurology, Developmental Paediatrics and Neurohabilitation Team Heads
Prof Virginia Wong
Professor
黃珍妮教授
Dr So-lun Lee
Consultant
李素倫醫生
Dr Ada Yung
Associate Consultant
楊穎欣醫生
Dr Cheuk-wing Fung
Associate Consultant
馮卓穎醫生
Dr Sophelia Hoi-shan Chan
Associate Consultant
陳凱珊醫生
Fellows:  
   
Ward manager: Ms Elisa Kit-ching Wong
Nurse Specialist : Ms Shirley Wai-sim Chan

Child Neurology started off as Developmental Paediatrics in our department. Over the past decade, there had been growing interest in the field of Developmental Paediatrics and Child Neurology. The programme had evolved to include Neuro-rehabilitation as part of the division over the past five years. In 1998, the division of Neuro-developmental Paediatrics overtook the tasks of assessment, management, re-assessment, habilitation and rehabilitation of children with the spectrum of developmental, behavioural or neurological disorders.

Activity & Service
The programme is unique in that it consists of comprehensive neurological, developmental and behavioural assessment of children and their families. The commonest disorders referred to the programme are speech and language disorders, autistic spectrum disorders, epilepsy, cerebral palsy, learning disabilities, specific learning disorders, brain tumours, hydrocephalus, spina bifida, neuromuscular disorders, attention deficit hyperactivity disorders, hearing disorders, visual impairment, behavioural problems, and neurocutaneous disorders.

We encourage active participation of parents and caretakers in our programmes. Parental involvement and support are essential for comprehensive care of these children, not only at home but also in the centre. We realize the parents of handicapped child often have enormous psychosocial stress. We provide respite care service to release their stress.

Developmental assessmentCombined comprehensive multi-disciplinary clinics had been set up to provide holistic care for children with various neurological or developmental disabilities. There were joint consultative clinics provided by the orthopaedic surgeons, paediatric surgeons, paediatric neurosurgeons, paediatric ENT surgeons, paediatric ophthalmologists, paediatric dental surgeons, paediatric gastro-enterologists, paediatric respirologists and paediatric psychiatrists.

Specialized programmes had been conducted, eg conductive education for children with cerebral palsy; gait analysis laboratory and spasticity clinic with various treatment modalities, such as intramuscular botulinum toxin injection, or selective dorsal rhizotomy; oro-motor rehabilitation clinic; drooling assessment clinic; feeding clinic; neurogenic bladder clinic; very low birth weight follow-up clinic; dysmorphic baby clinic; neurocutaneous clinic; and comprehensive epilepsy clinics for pre-surgical evaluation of intractable epileptics.

This programme had evolved into a very solid and comprehensive one for both undergraduate and postgraduate teaching and serves as a breeding ground for trans-disciplinary team work for children with disabilities.

DK Multi-disciplinary teamProfessionals of various disciplines including clinical psychologist, physiotherapist, occupational and speech therapists, nurses, optometrist and audiologist, and social worker work together to provide a comprehensive service of assessment and inter-disciplinary management.

Acute neurology and neurophysiology diagnosis are integral components of the service. The team provides acute neurological consultation in Queen Mary Hospital, Grantham Hospital and Tsan Yuk Hospital.

Strength & Development
Neuro-respiratory Rehabilitation CentreWe strive to provide a spectrum of mixed primary assessment, secondary treatment, and tertiary (inter-disciplinary management) care within the same setting tailored for children with disabilities. We also provide in-patient, day-patient, and out-patient neurodevelopmental professionals training.

The Child Neurology team is innovative, academic as well as inter-disciplinary. Multi-disciplinary clinics and specialized neuro-habilitative programmes were organized. Innovative programmes and new treatments are started in the context of on-going research.

Educational Programmes

  1. Organizing local, national and international symposiums:
    i. 3rd Huaxia Epilepsy Congress, 2002, Guangzhou, China.
    ii. 中華醫學會 (Chinese Medical Association) 兒科學會神經科專業組審稿會, 10-11 June 2002, Hong Kong.
    iii. Satellite Symposium of the Joint Congress of International Child Neurology Association and Asian Oceanic Child Neurology Association, The 9th International Child Neurology Congress and The 7th Asia & Oceanic Congress of Child Neurology, 18-19 Sept 2002, Hong Kong.
    iv. Joint Congress of International Child Neurology Association and Asian Oceanic Child Neurology Association, The 9th International Child Neurology Congress and The 7th Asia & Oceanic Congress of Child Neurology, 20-25 Sept 2002, Beijing, China.
    v. Joint Annual Scientific Meeting of the Hong Kong Epilepsy Society and the Hong Kong Neurological Society, 7-9 November 2003,Hong Kong.
  2. Participation in production of a Case Book of Neurology (2003) with Chinese University of Hong Kong, through Hong Kong Neurological Society.
  3. Conducted courses for Griffiths Mental Developmental Scale.

Research/ Grant & Awards
The Neuroscience Research Centre (NRC) established in the University of Hong Kong linked the basic neuroscientists and clinical neuroscientists together. We had been the chief clinical coordinator and actively participated in helping the Neuroscience Research Centre to bid for Neuroscience as the Area of Excellence (2001) in the University of Hong Kong with other departments like Anatomy, Physiology, Medicine, and Psychiatry.

We have started an Autism Research Programme and we are the first centre to be trained to use ADI-R for setting the gold standard for diagnosis of Autism for research collaboration in 2000. Our collaborator is Prof Catherine Lord, University of Chicago (Clinical & Research use of Autism Diagnostic Interview- Revised (ADI-R).

Active research projects
Innovative Research Projects of Integration of Traditional Chinese Medicine with Neurohabilitation- Herbal Medicine research in Attention Deficit and Hyperactivity Disorder; Tongue Acupuncture in Child Neurology (1997- 2000).
i. Trial of Traditional Chinese Medicine (Tongue Acupuncture) in Integrative Rehabilitation of Children with Encephalopathy (Cerebral Palsy/ Autism) (funded by RGC, HKU).
ii. Rett Syndrome- molecular genetic, cardiac and MRS study (supported by our department).
iii. Hair mineral analysis of children with neuro-developmental disorders.
iv. Use of Traditional Chinese Medicine (Tongue Acupuncture, TAC & Traditional Acupuncture) in improving functional ability of Motor Neuron Disease (MND), Spinal Muscular Atrophy (SMA) and Duchenne Muscular Dystrophy (DMD).
v. Double Blind randomized placebo control trial of using Tongue Acupuncture in cortical blindness using Functional brain mapping.
vi. Functional polymorphism of the transporter gene MDR1 in epilepsy-gene frequency and relation with multi-drug resistance: A pharmaco-genetic study in Chinese epileptics (funded by CRCG, HKU).
vii. ADHD.
viii. Neurofibromatosis.
ix. Quality of Life.
x. Genetic study in ADHD, Autism, Epilepsy, Marfan Syndrome.

Collaboration
Our team conducts multidisciplinary and interdisciplinary assessments for children with developmental, neurological or behavioural problems. Our team collaborated with other specialties for clinical service and research e.g. neonatology, neurosurgery, ENT surgery, orthopaedic surgery and radiology from Hong Kong West Cluster hospitals: Queen Mary Hospital, Grantham Hospital and Tsan Yuk Hospital to launch for several innovative Neuro- rehabilitation projects:

  • Intramuscular Botox Injection for Cerebral Palsy.
  • Selective Dorsal Rhizotomy (SDR) for Cerebral Palsy.
  • Cochlear Implant for Hearing Impaired Children.
  • Oro-motor Rehabilitation for Drooling and Swallowing Problem.
  • Comprehensive Epilepsy programme for Intractable Epilepsy.
  • Visual Training for Cortical Visual Impairment.
  • Pulmonary Rehabilitation for Neuromuscular Disease (Duchenne Muscular Dystrophy).
  • Study of Quality of Life in Cerebral Palsy, Intractable Epilepsy, Neuromuscular Disease.
  • Functional Independence Measure of Children (WeeFIM)- for objective evaluation of outcome for neuro-rehabilitation programmes.
  • Tongue Acupuncture for Intractable Neurological Problems.
  • Traditional Herbal Medicine for Children with Attention Deficit Hyperactivity disorder (ADHD).

All through these years, we have made regular exchange programmes with overseas centres. We provide neuro-developmental training to doctors and nurses from different parts of the world.

Paediatricians and Fellows from Beijing and Shanghai had been attached to our Rehabilitation Programme and these fellows started the first Children's Rehabilitation Programme in Shanghai Fudan University (2001) and Beijing Medical University (2002), which modeled after our programme. These were the pioneer Children's Rehabilitation Centres in China.

Team round

Regional & International Collaboration in clinical service and research

  1. First International Centre to be trained in using WeeFIM.
    i. Prof Carl Granger, Dr Susan Braun, University of Buffalo, Buffalo, New York, Uniform Data System (UDS) for Medical Rehabilitation, Research & Clinical use of Functional Independence Measure of Children (WeeFIM).
  2. Collaborate with International centres for Epilepsy Surgery for children with intractable epilepsy.
    i. Prof Jerome Engel, University of Los Angeles (Epilepsy Surgery Programme).
    ii. Prof Frederick Andermann, Montreal Neurological Institute (Clinical research in Epilepsy Surgery).
    iii. Prof A Simon Harvey, Epileptologist & Director, Children's Epilepsy Programme (RCH), Epileptologist, Comprehensive Epilepsy Programme (ARMC), Research Fellow, Brain Imaging Research Institute (ARMC), Murdoch Children's Research Institute (RCH), University of Melbourne (RCH), Department of Neurology, Royal Children's Hospital (Melbourne), Department of Neurology, Austin & Repatriation Medical Centre (Clinical research in Epilepsy Surgery).
    iv. Prof Harry Chugani, Department of Pediatric Neurology, Wayne State University (Clinical research in Epilepsy Surgery).
    v. Prof TT Wong, Prof CH Yiu, University of Taipei (Taiwan Veterns Hospital) (Clinical Research in Epilepsy in Chinese).
    vi. Prof CL Lai, University of Tsz Chai, Taiwan -Clinical collaboration with Epilepsy Centres of Chinese culture to set up PASG research programme.
  3. International Phase 4 Trials on New Anticonvulsants (2003).
  4. Establishment of International Stroke Registry (2003).
    i. Prof Gabrielle deVeber, University of Toronto (Establishment of an International Childhood Stroke Registry; Establishment of standards of practice and multi-centre, multi-national clinical trials for neonates and children with stroke)
  5. Establishment of the Eastern branch of the International SSPE Registry (2002).
    i. Prof Paul Dyken, Director, the International Registry of Subacute Sclerosing Panencephalitis (SSPE) (Establishment of Eastern Branch of the International Registry of SSPE)
  6. Establishment collaboration for study of Myasthenia Gravis.
    i. Prof Angela Vincent, Neurosciences Group, Institute of Molecular Medicine, John Radcliffe Hospital (Clinical and Basic Research in Myasthenia Gravis and Channelopathies).
    ii. Professor John Newsom-Davis, Department of Clinical Neurology, University of Oxford (Clinical and Basic Research in Myasthenia Gravis and Channelopathies).
  7. Hong Kong Epilepsy Society as a chapter of International League Against Epilepsy (2003).

Group photo