Pediatric Neurology

What Is Pediatric Neurology?

Pediatric neurology is a branch of medicine that aims to prevent, alleviate, diagnose and, wherever possible, treat neurological problems in children, and to improve the quality of life of children with neurological disorders.

What Is Pediatric Neurology?

Pediatric neurology is a medical specialty that evaluates and treats health problems related to children's nervous system. Neurologists check for various diseases affecting the brain, nerves and spinal cord in children. Following the evaluation, a range of treatments may be used, such as medication, physical therapy, speech therapy and special education programs.

A child's other illnesses can affect the development and function of the nervous system. For example, congenital thyroid dysfunction can lead to intellectual disability, and a stroke may occur in a baby with heart disease. Neurological emergencies are also common in children. Coma, stroke and seizures are among the most frequent emergencies. These neurological problems can cause permanent damage and may even be fatal. Neurological diseases do not affect only the children who suffer from them. Because they require treatment, rehabilitation and care, these conditions also indirectly affect the children's families and close circle. In addition, the fact that these children cannot take part in productive life, and that a large share of resources is continuously devoted to their care and treatment, makes neurological diseases a social issue.

What Are Pediatric Neurological Diseases?

Pediatric neurological diseases are highly diverse and may result from genetic, congenital, developmental, infectious, inflammatory, traumatic or metabolic causes. Neurological diseases that can be seen in children include:

• Autism spectrum disorder,

• Attention deficit hyperactivity disorder (ADHD),

• Dyspraxia,

• Learning disorders,

• Epilepsy,

• Febrile seizures,

• Lennox-Gastaut syndrome,

• Cerebral palsy,

• Dystonia,

• Huntington's disease,

• Meningitis,

• Encephalitis,

• Multiple sclerosis (MS),

• Tourette syndrome,

• Rett syndrome,

• Angelman syndrome.

What Are Pediatric Neurological Diseases?

Pediatric neurological diseases are highly diverse and may result from genetic, congenital, developmental, infectious, inflammatory, traumatic or metabolic causes. Neurological diseases that can be seen in children include:

• Autism spectrum disorder,

• Attention deficit hyperactivity disorder (ADHD),

• Dyspraxia,

• Learning disorders,

• Epilepsy,

• Febrile seizures,

• Lennox-Gastaut syndrome,

• Cerebral palsy,

• Dystonia,

• Huntington's disease,

• Meningitis,

• Encephalitis,

• Multiple sclerosis (MS),

• Tourette syndrome,

• Rett syndrome,

• Angelman syndrome.

What Are the Symptoms of Pediatric Neurological Diseases?

There are many neurological diseases seen in children. Each of these diseases may show very different or similar symptoms. The severity of the symptoms may also increase or decrease depending on how far the disease has progressed. For example, the main symptom of epilepsy is seizures. Symptoms of an epileptic seizure in children can be listed as follows:

• Fainting,

• Rapid breathing,

• Rapid heartbeat (tachycardia),

• Uncontrolled muscle movements,

• Repetitive movements,

• Inability to speak.

Since seizures vary from patient to patient, some symptoms may not be present in every patient who has a seizure. After a seizure, the child may also feel tired or confused because they did not realize they had a seizure. In cerebral palsy, another common condition, symptoms such as an unusually large or small head size, irritability, developmental delay and communication difficulties may be observed. Febrile convulsions are a common condition in children. In this case, the child's whole body shakes and they lose consciousness.

Autism is classified among neurological disorders and may begin to show signs from infancy. Signs of autism in a child may include:

• The child may not look when their name is called,

• The baby does not smile or show other joyful expressions by 6 months of age,

• The baby does not smile at their parents or others by 9 months of age,

• The baby does not use words such as “ba-ba” or “de-de” by 12 months of age,

• The baby does not make gestures such as waving by 12 months of age,

• The child cannot say any words by 16 months of age.

In addition to these developmental signs, the behavior of an autistic child also differs. While playing, they may line up their toys and always play with a toy in the same way rather than in different ways. Disliking loud noises, being very selective about food and licking objects that should not be licked are among the characteristics of an autistic child.

How Are Pediatric Neurological Diseases Diagnosed?

Neurological diseases in children can be diagnosed using many diagnostic methods. When you take your child to a specialist because of symptoms, a physical examination is performed first. Tests that may then be required include:

• MRI: Changes in the brain can be examined. Each disease has its own characteristic way of affecting the brain.

• Blood tests: These may be performed so that the child's symptoms are not confused with other diseases.

• EEG: The electrical activity of the brain is measured.

• Neurological examination: This examination can assess factors such as the child's muscle strength, how they respond to external stimuli and their attention.

• Lumbar puncture: This can be used in the diagnosis of meningitis.

Tests are chosen specifically for each disease. Therefore, not all of the above tests may be necessary, or a different test may be performed. Your doctor will make sure that the tests appropriate for your child are carried out.

How Are Pediatric Neurological Diseases Treated?

While some neurological diseases seen in children can be cured, in others the aim is only to relieve the symptoms. For example, there is no cure for cerebral palsy and autism. However, the frequency of symptoms can be reduced with medication, therapy and surgery. Medications may be prescribed to prevent seizures. Surgery in cerebral palsy is performed to prevent muscle spasms. Therapy is a treatment method used for children who have difficulties with communication. For other neurological diseases, physical therapy, oxygen support and fever-reducing medications may be used.

Frequently Asked Questions About Pediatric Neurology

Areas of Interest in Pediatric Neurology

• Neurological follow-up of high-risk babies (all premature babies and babies who experience various problems at birth or in the newborn period that may affect the brain)

• Delay in developmental milestones (fine and gross motor, language and personal-social areas)

• Floppy infant (hypotonia)

• Headache (migraine type, tension type, mixed type, etc.), migraine variants

• Dizziness (vertigo)

• Febrile seizures (febrile convulsions), breath-holding spells, afebrile seizures (afebrile convulsions), conditions that mimic seizures

• Epilepsy

• Cerebral palsy

• Intellectual disabilities and accompanying conditions

• Autism – pervasive developmental disorder spectrum

• Speech and language disorders

• Sleep disorders (insomnia, parasomnia)

• Children with congenital or acquired brain anomalies

• Diseases affecting the muscles and the neuromuscular junction

• Diseases affecting the peripheral nervous system (hereditary and acquired neuropathies)

• Movement disorders (tremor, tics, chorea, athetosis, ballismus)

• Neurometabolic diseases (metabolic diseases are common in our country due to consanguineous marriages; the most common is phenylketonuria)

• Progressive neurodegenerative diseases with loss of acquired skills

• Neurogenetic diseases with dysmorphic features

• Mitochondrial diseases

• Neurocutaneous diseases (tuberous sclerosis, neurofibromatosis, Sturge-Weber, etc.)