Pediatric neurology
Pediatric neurology deals with the treatment of conditions affecting the nervous system in children, from infancy to adolescence. Neurologists are doctors who deal with the diagnosis and treatment of diseases and disorders that affect the nervous system, including the brain, spinal cord, peripheral and autonomic nervous systems, along with their related blood vessels and muscles.
A child will often present to a pediatric neurologist after having been referred by a child’s pediatrician or even by another specialist when the primary diagnosis suggests the presence of a neurological disorder. In many cases, though, a parent will first seek care for a pediatric neurologist when they have suspected their child has been exhibiting a symptom that could suggest the presence of a neurological disorder.
What Conditions Do Pediatric Neurologists Treat?
Pediatric neurologists oversee disorders affecting the nervous system and brain in children. They can be genetic or congenital, or they may develop due to trauma. The ambit is extremely wide and extends to include muscle problems such as muscular dystrophy, other diseases, epilepsy, Tourette’s syndrome, and several developmental disorders.
Some experts in this field are keen on specializing only in particular sub-specialties and not the general pediatric neurology. Some possible specialties include areas like autism, complex metabolic disorders, muscle and nerve diseases, genetic neurological conditions, and congenital malformations.
Common Pediatric Neurological Disorders:
1. Epilepsy and Seizure Disorders:
Definition: Epilepsy is a chronic neurological disorder that characterizes recurrent, unprovoked seizures caused by abnormal electrical activity in the brain. It may present in various types of seizure, including generalized seizures, which are sub-classified as follows: absence seizures, tonic-clonic seizures and; focal seizures.
Symptoms: Lack of consciousness, convulsion, staring spell, or repetitive movements. The seizures may range from frequent to rare and mild to severe.
Treatment: The majority of treatment involves antiepileptic drugs; in more severe cases, surgery, ketone therapies, or vagus nerve stimulation.
2. Cerebral Palsy (CP):
Definition: CP is a group of disorders that impair movement and muscle tone or posture, often affecting people at different times and in varying degrees; these symptoms occur due to non-progressive brain injuries or malformations sustained before, during, or at term following birth; CP is the most common motor disability in childhood.
Symptoms: Muscle spasticity, chorea, ataxia, and delayed motor development milestones, like walking or sitting.
Treatment: The child can be treated with physical therapy, occupational therapy, speech therapy, and medications to control spasticity, such as botulinum toxin and baclofen. Surgery is necessary for extreme cases.
3. Autism Spectrum Disorder (ASD):
Description: ASD is a developmental disorder that influences communication, behavior, and social interaction. It has a wide variety of symptoms and abilities. That’s why there is the term “spectrum” disorder.
Manifestations: The spectrum of symptoms may have difficulties in social communications and interactive behaviors, restricted or repetitive behaviors, and sensory sensitivities. These symptoms are often evident during early childhood.
Treatment: Behavioral therapies can comprise of such interventions as Applied Behavior Analysis, speech and language therapy, occupational therapy, and medications might be prescribed for concomitant conditions like anxiety or hyperactivity.
4. Developmental Delays:
Description: A developmental delay is the failure to reach a developmental milestone within the time frame expected. In other words, it is the delay in reaching certain milestones either in speech, motor skills, cognitive, or social development.
Symptoms: Waving, talking delayed social interaction, or problem-solving skills.
Treatment: The focus is on early intervention. Some of the very common interventions include physical, occupational, and speech therapy.
5. Attention Deficit Hyperactivity Disorder (ADHD):
Description: ADHD stands for attention deficit hyperactivity disorder. It is a neurodevelopmental disorder that incorporates symptoms of inattention, hyperactivity, and impulsivity that thwart the ability to focus and act behaviorally by a child.
Symptoms: Trouble paying attention, restlessness, impulsive behaviors, and difficulties with organization or completion of tasks.
Treatment: Behavioral therapy, parent training and medications (stimulant, such as methylphenidate; nonstimulant, such as atomoxetine).
6. Muscular Dystrophy:
Description: Muscular dystrophies are a group of genetic disorders characterized by progressive weakness and degeneration of the muscles. The most common in children is Duchenne Muscular Dystrophy (DMD).
Symptoms: Progressive muscle weakness, problem with walking, frequent falls, reduction of muscle mass. Symptoms for DMD typically begin around the time of age 3-5 years old and progressively worsen from there.
Treatment: Physical therapy, corticosteroids to retard muscle wasting, assistive devices- braces, wheelchairs. Genetic therapies are being developed for treatment of the cause.
7. Hydrocephalus:
Hydrocephalus is defined as an excess accumulation of cerebrospinal fluid within the brain with increased pressure on the tissue of the brains. Hydrocephalus may be congenital or acquired.
Symptoms: In babies, signs may include an enlarged head, vomiting, irritability, and failure to thrive. In older children, it is characterized by headaches, nausea, and loss of balance
Treatment: Surgery, usually placing a shunt to drain away excess fluid or endoscopic third ventriculostomy ETV.
8. Spina Bifida
Description: It is a birth disorder in which the development process of the spinal cord as well as other surrounding structures does not happen properly, so that the spine leaves a flawed opening. This is one of the most common neural tube defects.
Symptoms: These may vary in intensity but can include paralysis of the legs, bowel and bladder dysfunction and learning difficulties.
Treatment: Surgery is usually required shortly after delivery to close the spinal defect. Ongoing care includes physiotherapy, assistive aids, and management of bladder and bowel issues.
9. Headaches and Migraines:
Description: Headaches are common in children. It hugely affects the life of a child. Migraines are severe usually combined with nausea, vomiting, sensitivity to light and sound.
Symptoms: Headache, nausea, vomiting, photophobia and phonophobia in migraines, irritability, and poor concentration.
Management: Analgesics over-the-counter for simple cases, prescription when the cases are complicated, lifestyle changes, and triggers.
10. Neurogenetic Disorders:
Definition: These conditions are resulting from genetic mutations that affect the development and functioning of the nervous system. Some of them include Rett syndrome, Fragile X syndrome, Angelman syndrome, among many others.
Symptoms: There might be problems in developing normally, intellectual disabilities, difficulty walking or movement, seizures, among others. Characteristic behavioral or physical features.
Treatment: Supportive care with physical, occupational, and speech therapies. Genetic counseling also can be recommended.
11. Tic Disorders and Tourette Syndrome:
Definition: Tic disorders are characterized by recurrent, repeated movements or vocalizations that are repeated. Tourette syndrome is a more severe tic disorder in which typically begins in childhood.
Symptoms: Motor tics that may include blinking, shrugging; and vocal tics such as grunting and throat clearing. Multiple motor and vocal tics are typical of Tourette syndrome.
Treatment: Behavioral therapy such as Comprehensive Behavioral Intervention for Tics, drugs that help in reducing the occurrence of tics, and supportive care from related conditions like ADHD or OCD.
Diagnosis in Pediatric Neurology:
Pediatric neurologists use a variety of diagnostic tools to assess neurological disorders in children:
- Clinical Examination: Neurological exams to assess motor skills, sensory function, reflexes, and coordination.
- Developmental Assessments: Testing to evaluate a child’s cognitive, motor, language, or social skills.
- Neuroimaging: Techniques like MRI or CT scans to visualize the brain and spine and detect abnormalities such as tumors, lesions, or malformations.
- Electroencephalogram (EEG): Used to detect abnormal electrical activity in the brain, especially in epilepsy.
- Genetic Testing: To identify mutations associated with neurogenetic disorders.
- Lumbar Puncture: Used to test cerebrospinal fluid for infections, inflammation, or other abnormalities.
Reasons to See a Pediatric Neurologist
If your child exhibits some or all of the following, your pediatrician or family doctor may refer him or her to a pediatric neurologist.
- Persistent or severe headaches
- Balance problems
- Recurring fainting or loss of consciousness without an obvious cause
- Memory or concentration problems
- Neurological pain
- Numbness, loss of sensation, or tingling
- Mobility problems
- Shakiness
- Developmental delays
- Walking or other coordination problems
- Uncontrollable movements or tics
- Seizures
- Coordination problems or other difficulties with motor skills
At our Neurosys Multispeciality Center, we perform several key procedures including Craniotomy, which is primarily for the excision of brain tumors; V-P Shunt Surgery for treating hydrocephalus; surgeries for epilepsy; and operations targeting brain stem glioma. Beyond these, we offer a range of other neurosurgical services. If you have any questions that are not answere, please contact us through our Contact Us or Book your Appointment.