Pediatric Neurology

Sudden injuries, infections, or traumatic events that damage the brain or nervous system. They may require emergency medical treatment. Examples include:

Brachial plexus injuries

Injuries to the bundle of nerves located where the shoulder and neck join together. Because these nerves are responsible for movement and sensation in the shoulder, arm, and hand, injuries can result in pain, tingling, numbness, and muscle weakness — up to paralysis in serious cases. Babies can injure their brachial plexus during birth and delivery.

Near-drowning accidents

Severe oxygen deprivation while submerged can cause lasting damage to the brain, potentially leading to cognitive problems such as memory loss, communication difficulties, changes in mood or behavior, reduced control and coordination of movement, and others.

Spinal cord injury

These injuries often cause a permanent reduction or loss of ability to feel or control parts of the body below where the spinal cord was damaged.

Stroke

Part of the brain is suddenly cut off from blood supply, whether due to a blocked blood vessel (ischemic stroke) or bleeding (hemorrhagic stroke). Initial symptoms include sudden difficulty with speaking and understanding language, partial paralysis or drooping of the face or limbs, and severe headache. If you see any of these signs in your child, call 911 immediately.

Traumatic brain injuries (TBIs)

Bumps, jolts, or shakes to the head can cause the brain to jostle around in the skull. This can cause physical damage and chemical changes to the brain. Symptoms can include temporary loss of consciousness at the time of injury, as well as headaches, balance issues, and difficulties with cognitive functions (such as learning, memory, problem solving, or mood disorders) that can persist. Concussions are a mild form of traumatic brain injury.

These conditions affect a child’s ability to move and use their muscles. Movement disorders are central nervous system (brain and spinal cord) conditions that can cause involuntary motions like tremors, shaking, or slow and restricted motions. Neuromuscular disorders are caused by problems with the peripheral nerves that directly control muscles, and often result in symptoms like muscle weakness, cramping, and twitching. Examples include:

Balance disorders

Conditions that cause dizziness or unsteadiness when standing or walking.

Gait disorders

Difficulty with balance or abnormal walking patterns, such as limping, walking on tiptoes, or intoeing (walking with feet turned inward, commonly called “pigeon toes”). They are sometimes caused by movement disorders or other nervous system issues.

Juvenile parkinsonism

Children with this syndrome develop symptoms similar to Parkinson’s disease before age 21. These can include tremors, stiff muscles, difficulty balancing, and slowed movements.

Muscular dystrophy

A group of diseases that causes muscles to lose mass and become gradually weaker over time. Symptoms often begin in early childhood.

Spasticity

This is a general term that refers to stiff, rigid muscles that become difficult to move or contract involuntarily. It can be caused by a wide range of neurological issues, including stroke, cerebral palsy, or injuries to the brain or spinal cord.

Spinal muscular atrophy (SMA)

Children with SMA have muscles that get progressively weaker over time due to increasing damage to the motor neurons of the spinal cord. Severe cases often begin showing systems at or shortly after birth, while milder cases may not become noticeable until your child is 18 months or older.

Tourette syndrome

This condition causes repetitive, sudden, and involuntary movements (motor tics) and/or vocalizations (vocal tics) that can’t be easily controlled.

Tremors

Any involuntary, rhythmic shaking of a body part, such as the hands, arms, legs, or head.

Abnormal growths of brain tissues. Symptoms can vary depending the size and location of the tumor, but may include headaches, nausea, and sensory difficulties. Depending on the circumstances, your child’s neurologist may recommend observation or non-surgical treatments, or refer you to a pediatric neurosurgeon. Examples include:

Neurofibromatosis

These genetic conditions cause tumors to develop on nerve tissue throughout the body. Symptoms of the most common type that develops in children (Type 1) can include café-au-lait spots (splotchy coffee-colored patches of skin), soft bumps on skin, and learning disabilities.

Spinal tumors

Abnormal masses of tissue along the spinal cord or other parts of the spinal column. Symptoms vary widely but can include pain, numbness, muscle weakness, loss of muscle coordination, and loss of bowel or bladder control.

Tuberous sclerosis

This condition causes tumors to develop in several different parts of the body, but most commonly in the brain. While the tumors are not cancerous, they can cause seizures, developmental delays, and other brain disorders.

These conditions are caused by abnormal growth or development of the brain or nervous system before birth or in early childhood. They include:

Brain malformations and abnormalities

Structural or functional problems with the brain that emerge during development. For example, parts of the brain may be too small, too large, missing, or affected by abnormalities in the shape and development of skull bones (craniofacial anomalies). Symptoms vary widely depending on the location and severity of the abnormalities.

Cerebral palsy

This term includes several conditions that inhibit a child’s ability to control movements and posture. Common symptoms include muscles that are too stiff (or too limp), exaggerated reflexes, tremors, and difficulty walking.

Dandy-Walker syndrome

Children with this condition are born with an underdeveloped cerebellum at the back of the brain. Symptoms are usually noticeable in infancy and often include an enlarged skull, delays in motor development (e.g. crawling, walking, etc.), low muscle tone, stiff muscles, and jerky movements.

Fetal alcohol and drug exposure

Drugs or alcohol that a mother takes while pregnant can easily pass along to their unborn child. This exposure can negatively affect brain development.

Hydrocephalus

Excess cerebrospinal fluid builds up in natural cavities within the brain, called ventricles, and enlarges them. This can damage the brain and may be life-threatening. Symptoms can sometimes develop rapidly and may include increased infant head size, nausea, irritability, seizures, headaches, or vision problems. Treatment requires surgery, but your child may work with a neurologist to manage any related neurological complications.

Hypotonia

Children are born with too little muscle tone. Babies born with this condition may struggle to hold their head up or feel limp and droopy when held, and they may have difficulty with feeding. Development of other motor skills (such as sitting, crawling, and walking) may be delayed.

Hypoxic events at birth

If a newborn’s brain doesn’t get enough oxygen or blood flow during or shortly after injury, it can result in brain damage.

A seizure is a surge of electrical activity in the brain, which can cause a variety of abnormal symptoms (such as disorientation, confusion, jerking motions, or loss of consciousness). Seizure-related conditions include:

Autoimmune conditions (autoimmune epilepsy)

Several conditions trigger the body’s immune system to attack healthy brain cells. This can trigger electrical discharges that cause seizures.

Epilepsy

This is a general term for any disorder that causes brief, reoccurring seizures, regardless of the underlying cause. A child with epilepsy will tend to have similar symptoms each time they have a seizure, but symptoms can vary significantly between different children with the condition.

Neuroinfectious diseases

Infections of the brain or nervous system caused by bacteria, viruses, parasites, or other germs. Examples include meningitis, neurocysticercosis, and toxoplasmosis. Symptoms vary widely based on the specific infection but often include seizures.

A pediatric neurologist may be part of your child’s care team for many other conditions that can affect the brain or nervous system. These include:

Congenital heart disease

See pediatric cardiology

Headaches

See pediatric primary care

Inherited metabolic disorders (enzyme disorders)

These genetically inherited conditions interfere with the body’s ability to produce specific enzymes that break down complex molecules from food (such as fats, sugars, and protein). As a result, the unmetabolized molecules may build up to toxic levels in the body’s cells — including the brain, where they can lead to seizures, developmental delays, and other neurological issues. Subcategories include amino acid disorders, fatty oxidation disorders, lysosomal storage disorders, organic acid disorders, urea cycle disorders, and many others.

Lead poisoning

See pediatric primary care

Lupus

See pediatric rheumatology

Memory disorders

Conditions that interfere with the brain’s ability to create new memories or access existing memories. A pediatric neurologist may treat underlying brain conditions that cause memory problems, while a pediatric neuropsychologist can help your child with memory training exercises and rehabilitation.

Multiple sclerosis (MS)

The body’s immune system attacks the brain and spinal cord, disrupting their ability to communicate with the body. Over time this can lead to symptoms such as muscle weakness, difficulty with balance and coordination, and vision loss.

Neurodegenerative diseases

These chronic diseases gradually damage and destroy nervous system tissues over time. Symptoms depend on the specific condition and type of nerve tissue being targeted, but they can involve cognitive functions, senses, and movement.

Neurovascular conditions

These conditions affect blood vessels in the brain, spinal cord, or other nerves. Vessels may be too narrow (restricting blood flow), excessively fragile and prone to ruptures or bleeding, or have an abnormal structure or abnormal connections.

Sleep-wake regulation disorders

See pediatric pulmonology and sleep health

Spina bifida

A portion of the spine doesn’t fully close before birth, leaving part of the spinal cord exposed. This can cause a variety of symptoms depending on the severity.

Vascular malformations of the central nervous system

Blood vessels in the brain or spinal cord that develop abnormally — for example, forming irregular connections between arteries (which are supposed to carry oxygen-rich blood to the brain) and veins (which take oxygen-depleted blood back to the lungs and heart).

We provide a wide range of treatment options for kids with epileptic seizures. Our doctors work to identify the root causes or triggers of seizures and provide the most effective and least invasive therapies appropriate for your child. Services include:

Dietary therapies

Certain low-carb diets, including the ketogenic diet and a modified Atkins diet, can help children manage specific forms of epilepsy. Our team can help you determine if this approach would be healthy for your child.

Mobile Epilepsy Monitoring Unit

State-of-the-art wireless technology allows children and parents to move freely around the unit (including the playroom) while our team monitors their brain activity during the testing period, which can last several days. We are the only hospital in the state with this service.

Neuromodulation therapies

Doctors implant a small device under the skin that sends mild electrical impulses to the brain, which can prevent or reduce the severity of seizures. It may help with specific forms of drug-resistant epilepsy. Options include nerve stimulation (implanted in the chest to send regular pulses to the brain) and responsive neuromodulation (implanted in the head and generates pulses only when a seizure is detected).

Pre-surgery evaluation

If surgery is recommended, we help the pediatric neurosurgery team evaluate and determine the best surgical approach. We use a variety of advanced, non-invasive, and radiation-free imaging technologies to precisely map the brain.

This program offers a wide variety of medical and surgical treatment options for children with movement disorders, such as muscle stiffness and spasms (spasticity conditions including cerebral palsy), Tourette syndrome, and many others. Our team has the only fellowship-trained movement pediatric disorder specialist as well as the only pediatric functional neurosurgeon in the state of Michigan. Treatment options include:

Muscle-relaxing medications

These include Botox (which can temporarily paralyze specific, stiff muscles) and baclofen (which targets neurotransmitters to provide a body-wide muscle relaxation effect). For children with severe spasticity, a baclofen pump can be implanted to automatically provide doses.

Rehabilitation

Our team works closely with medical and rehabilitation specialists to help children regain as much strength and movement control as possible.

Advanced brain imaging

We offer advanced technology like magnetoencephalography (MEG), a non-invasive, radiation-free, and dye-free imaging tool that uses extremely sensitive scanners to pinpoint abnormal electrical activity in the brain down to the millimeter. Other imaging services include magnetic resonance imaging (MRI) and electroencephalography (EEG).

Botox injections

Botox can relax muscles and block pain signals in specific locations. It may be used to treat chronic headaches and muscle stiffness.

Gene therapy infusions

Doctors deliver working copies of a gene into a child’s body to compensate for a missing or defective gene that isn’t working properly. This can be an effective treatment for certain genetic conditions, including spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD).