Pediatric Neurology

Pediatric Neurology

Pediatric brain and nerve disorders are common conditions, although they can be hardly recognized even by deliberate parents. Permanent disabilities can be avoided by long-term treatment and follow-up of conditions, including but not limited to epilepsy, episodic apnea (breath-holding spell), febrile convulsion, syncope, headache, enuresis, attention deficit, learning disability, sleep disorder, posture instability, gait disorder, neurological developmental retardation, cranial trauma, birth trauma, facial palsy, spasticity and hypotonia.

Epilepsy: 

Epilepsy, which is sometimes called a seizure disorder, is a disease that occurs suddenly as a result of a disorder in the normal functioning of the brain, affects the consciousness and behaviors of the individual and recurs in the form of seizures. Approximately half of the children between the ages of 6 months and 5 years with a history of febrile convulsion develop epilepsy at a later age. Antiepileptic drugs are used to treat this disease that is treatable in approximately 65% of children who exhibit normal development. Surgical intervention may also be an option in some cases.

Headaches: 

The age of onset of headaches, which are a frequent occurrence also in children, is usually 8 to 9 years. Radiological imaging can be called in to clarify the underlying cause of headaches if deemed necessary by the physician based on the patient’s anamnesis and findings of physical and neurological examination. Usually triggered by tension-type headache, migraine or sinusitis, this condition may also be caused by tumor presence, an abscess or simply psychological reasons. Treatment is arranged by the pediatric neurologist according to the patient's condition, after having clarified the cause.

Dizziness: 

The incidence of vertigo in children is approximately 6%. It is important to provide the physician with accurate information about how and when the child experiences dizziness. Physical and neurological examination is performed to see whether the cause of dizziness if of a central or peripheral nature. Major determinants are trauma history, whether the dizzy spells are of a recurring nature and whether they are accompanied by headaches, fever, hearing loss or changes in consciousness. Dizziness can be caused by simple reasons such as motion sickness, or congenital anomalies as well.

Cerebral Palsy: 

Cerebral Palsy (CP) is a group of disorders that affect a person’s ability to move and maintain balance and posture, caused by injury to the brain in the womb, during birth or before the age of 2. Sometimes also referred to as “brain paralysis”, the symptoms of this condition vary according to the location and extent of brain injury. There are several preventable causes that can lead to this disorder, including preterm birth, blood pressure changes of the expectant mother, blood incompatibility, or perinatal asphyxia. Although damage is irreversible, early diagnosis and treatment are of utmost importance for the child to develop and master various skills.

Infantile Hypotonia: 

Colloquially known as floppy baby syndrome, this condition manifests itself in form of decreased muscle tone in an infant’s arms and legs. Its characterized by the presence of ‘frog-leg’ posture. The baby’s head will fall forward when the infant is held under the arms. The causes of this syndrome can be anomalies in brain development or muscle diseases, while mild cases of this syndrome in some babies can heal spontaneously after the age of 2. Detailed examination by a specialist physician is required.

Movement Disorders: 

The most common movement disorder in children is tic disorder. Sydenham’s Chorea and dystonia are also among the most prevalent movement disorders. This condition is often caused by damage during brain development, called cerebral palsy. Yet it may also develop as a result of drug side effects, bleeding, trauma, meningitis, encephalitis or genetic characteristics. Physical examination, laboratory tests and radiological imaging may be required for diagnosis. The patient’s quality of life can be improved through medication and surgical intervention.

Neurodevelopmental Delay: 

This condition that can be defined as a child’s failure to meet developmental milestones in due time can be described as delayed development of fine and gross motor skills like walking, running, sitting, eating or painting compared to peers. An important symptom is delay in reaching age-appropriate monthly milestones. Children who exhibit symptoms of this condition should be examined in detail.

Muscle and Peripheral Nervous System Disorders: 

Muscle disorders that can be defined as dysfunction as a result of deformities due to weakness or shortening of muscles are mostly inherited. The types of these disorders are multifarious, with types of SMA being the most prevalent ones. Disorders affecting the peripheral nerves are characterized by weakness in or under the knee region or in hands. These disorders, which can be seen until the age of 20, usually show symptoms such as weakness, fatigue, difficulty in walking, and hand disorders. A pediatric neurologist should be consulted for the diagnosis and treatment of these disorders that have many different subtypes.

Autism and Pervasive Developmental Disorders: 

Pervasive developmental disorders lead to dysfunctions in which a child has difficulty understanding and speaking its mother tongue, cannot establish connections between events, people and objects, and exhibits repetitive behaviors and movements. The most prevalent form of these disorders is autism which is a disorder that prevents social interaction with other people, with the onset of symptoms usually between the ages 1 to 3.

There are many other diseases and disorders originating from the brain or nervous system that fall into the scope of pediatric neurology. Detailed anamnesis is key to correct diagnosis. If deemed necessary subsequent to physical and neurological examination, the specialist physician will apply diagnostic aids including radiologic methods such as EEG, MRI or cranial ultrasonography and certain metabolic and developmental assessment tests. Once the diagnosis is clarified, treatment is arranged considering the patient’s current condition. Do not forget to get routine health checks done both for yourself and your loved ones for a healthy life.