- What is Child Neurology?
Child Neurology focuses on the issues concerning the development and maturation of the nervous system(brain and spinal cord) and disease affecting the nervous system in children upto 18 years of age.
- What is the need and scope for monitoring the development of children?
There is a normal variation in achieving milestones in different children who are otherwise normal. Hence there is a need to detect the “abnormal from the normal” early so that appropriate investigations can be done for detecting cause and institute early treatment or interventions.
- What is developmental screening?
Developmental screening is a procedure designed to identify children who should receive more intensive assessment for detecting potential delays.
- What is developmental surveillance?
Child development is a dynamic process and difficult to quantitate by a one-time assessment. During surveillance repeated observations on development are made by a skilled caregiver over time to see the rate and pattern of development.
- What are birth defects?
Birth defects are abnormalities of structure, function or metabolism (body chemistry) present at birth (congenital) that results in physical or mental disability.
- What causes birth defects?
Birth defects can be caused by defective gene function, pregnancy related problems like intra uterine infections, uncontrolled diabetes and exposure to certain drugs, alcohol,chemicals or toxins during pregnancy.
- What are the consequences of these birth defects?
Birth defects can cause either physical defects or developmental disabilities.
- What are neural tube defects?
Neural tube defects are birth defects related to the growth and development of the brain and spinal cord. It includes conditions like spina bifida, in which the membranes around the spinal cord don’t close properly and a part of the spinal cord comes out through the defect (myelomeningocoele). People with spina bifida may have problems with walking and controlling urination and passing stools.
- What are the developmental disabilities caused by the birth defects?
Developmental disabilities caused by birth defects are those that cause lifelong problems with how a body part or system works. They affect the brain, spinal cord and nervous system functioning causing mental retardation, learning and behavioral disorders and certain degenerative disorders like Rett syndrome and Adrenoleucodystrophy. Some of them might become apparent only when children are grown older.
- How are children with developmental disabilities managed?
The management of children with developmental disabilities revolves around screening and early detection of the disability, finding the cause of the disability by appropriate imaging, metabolic genetic and neuro-electro physiological tests as required.
- Is there a cure for these developmental disabilities?
Though a majority of the developmental disabilities have no cure, it is possible to prevent the progression and limit the disabilities by appropriate treatment strategies.Physical, speech and occupational therapy, special education classes and psychological counseling can also help.
- What are the causes for fits in children?
In majority of cases,the cause is not clear, the so called idiopathic epilepsies. These are more common in childhood and adolescence and some of them may run in families.Injury to the brain during birth and development derangements of brain are two important known causes for fits in children. Febrile fits is special situation in children between 6 months and 6 years of age, where children gets fits during episodes of fever.
- What is the treatment of fits?
In case an under lying cause of seizures is detected, appropriate treatment for the cause is initiated. In majority of cases, anti epileptic medications can control the seizures effectively. A small proportion of children continue to have uncontrolled seizures despite the best medical treatment, in whom surgical treatment may be tried.
- What is Cerebral Palsy (CP)?
Cerebral Palsy is primarily a disorder affecting the movements and actions performed by various muscles of the body (motor disorder). Though described as non progressive the disability (due to the damage sustained at a time during early childhood) can progress.
- How is CP managed?
The management of CP revolves around the management of associated conditions (like seizures, mental sub-normality, visual and hearing loss) prevent the progression of disability and rehabilitation.
- Who does the CP management team consist of?
The CP management team consists of a pediatric neurologist, developmental pediatrician,physiotherapist, a child psychologist, orthopedic surgeon, speech therapist,occupational therapist and a social worker. The neurologist coordinates the functioning of the tam and is primarily involved in diagnosis, assessing development and disability. Control of fits if any and determining the need for any interventions-medicines, surgery or otherwise.
- What are the other causes of motor disability in children?
The muscle diseases like myopathies and muscular dystrophies constitute a major cause for motor disability in children. The aim of management of these children is towards diagnosis, reducing disability, rehabilitation and in some cases genetic counseling.
- How can a child with a muscle disease diagnosed and managed?
The diagnosis of the muscle disease is based on the careful assessment of the child,electro physiological investigations like NCS, EMG, blood enzyme analysis,muscle biopsy and genetic studies. The parents of such a child need to be counseled at the possibility of having another child with a similar illness and how to prevent the same (genetic counseling).
- Finally why child neurology?
Children are not miniature adults. They are growing and maturing. The physiology and hence the way they react to disease processes is different from adults. Hence children with neurological problems need attention by child neurologist.