Pediatric Neurology

Central nervous system (brain or spinal cord) disorders that cause problems with movement or posture, such as involuntary tremors, slow or restricted motion, or other issues. Examples include:

Balance disorders

Conditions that make a child feel dizzy, unsteady, or out of balance when standing or walking.

Gait disorders

Abnormal walking patterns, such as limping, walking on tiptoes, or walking with toes pointed inward or outward. Nerve damage, movement disorders, or other neurological conditions may be the root cause.

Spasticity

This term refers to muscles that have become stiff and difficult to move. They may also painfully contract (tighten) involuntarily. Many neurological conditions can cause spasticity, including cerebral palsy, stroke, or traumatic injuries to the brain or spinal cord.

Tourette syndrome

This condition causes tics, which are sudden, unwanted, and uncontrollable movements (motor tics) or vocal sounds (vocal tics).

Abnormal growths of tissue on, or within, the brain or nerves. Examples include:

Brain tumors

Abnormal tissue growths in, on, or near the brain. They can result in a variety of physical, cognitive, emotional, and motor control symptoms based on where the tumor is located. They can be cancerous or non-cancerous.

Neurofibromatosis

A group of genetic conditions that cause non-cancerous tumors to form on nerves throughout the body. Symptoms vary depending on the disease, but the most common childhood type (Type 1) includes coffee-colored birthmarks (café-au-lait spots), soft bumps on skin, and learning disabilities.

Spinal tumors

Masses of tissue located in or around the spinal cord or spinal column that surrounds it. Symptoms can vary, but they may cause pain, numbness, muscles weakness, and loss of control over muscle coordination, bowels, or bladder.

Tuberous sclerosis

This condition causes non-cancerous tumors to form in various organs throughout the body, but most frequently in the brain. Symptoms can include seizures, developmental delays, and other brain disorders.

These conditions occur if the brain grows or develops in an abnormal way, before birth or in early childhood. They include:

Brain malformations and abnormalities

Abnormal physical structure or function of the brain that is typically already present at birth — for example, portions of the brain may be enlarged, small, missing, or misshapen due to problems with the skull bones (craniofacial anomalies).

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 difficult walking.

Dandy-Walker syndrome

This condition causes the cerebellum, the structure at the back of the brain that is important for many cognitive and motor functions, to be underdeveloped. Symptoms can include an enlarged head, low muscle tone, delayed crawling and walking, stiff muscles, low muscle tone, or jerky motions.

Fetal alcohol and drug exposure

If a mother takes drugs or drinks alcohol while pregnant, those substances can pass along to their unborn child and interfere with healthy brain development.

Hydrocephalus

Natural cavities within the brain (called ventricles) fill up with excess cerebrospinal fluid, causing those spaces to swell. This can develop rapidly and be life-threatening. Signs may include a rapid increase in infant head size, nausea, irritability, seizures, headaches, or vision problems. Surgery is required to treat this condition, but your child may also work with a neurologist for any necessary post-surgical supportive therapies.

Hypotonia

Children with this condition have too little muscle tone. They may look or feel droopy or limp when held and may have difficulty or take longer to develop motor skills like crawling and walking.

Hypoxic events at birth

These occur if a newborn doesn’t get enough oxygen or blood flow during or shortly after birth. The lack of oxygen can damage the brain.

Neonatal seizures

Electrical surges in the brain, which often causes sudden and uncontrolled movements (such as eye fluttering, bicycling limb movements, or chewing motions) in newborns. Testing may be required to confirm a diagnosis, since these movements may be hard to distinguish from normal newborn behavior.

These disorders are caused by dysfunction in the peripheral nerves responsible for directly controlling muscles. They include:

Muscular dystrophy

This includes a variety of diseases that cause muscles to gradually degenerate and weaken over time. Symptoms often start in early childhood.

Spinal muscular atrophy (SMA)

This condition causes muscle weakness that worsens over time as motor neurons of the spinal cord begin to fail prematurely. More severe forms of the disease may be noticeable at or shortly after birth, while the mildest forms may not be noticeable until your child is at least 18 months old (and sometimes much older).

Sudden injuries that damage the brain or nervous system. Examples include:

Near-drowning accidents

Underwater suffocation can cause lasting damage to the brain if it is cut off from oxygen for too long. Potential complications include cognitive and movement difficulties, including memory loss, communication difficulties, mood disorders, and reduced motor control.

Traumatic brain injuries (TBIs)

Sudden shakes, jolts, or blows to the head can cause the brain to collide with the inside of the skull, leading to physical damage or chemical changes. Symptoms can vary widely in severity and duration but can include temporary loss of consciousness, headaches, balance issues, and persistent cognitive or emotional difficulties. Mild TBIs are also known as concussions.

A pediatric neurologist may be part of your child’s care team for many other brain and nervous system conditions, including:

Arteriovenous malformations (AVM)

Abnormal development of blood vessels that create a tangled web of arteries and veins that connect to each other in ways they aren’t supposed to. This can prevent enough oxygen-rich blood from getting to certain body tissues. While they can happen anywhere in the body, they are especially common in and around the brain and spinal cord.

Brain aneurysm

A weak spot in the wall of an artery in the brain that begins to bulge and may eventually leak or rupture, which can cause life-threatening bleeding in the brain (hemorrhagic stroke).

Cavernous malformation (cavernoma)

An abnormally dense cluster of small blood vessels (capillaries) with especially thin walls that are prone to bleeding. They are especially common in the brain and spinal cord.

Epilepsy

This condition causes, brief, reoccurring seizures, which are abnormal electrical surges in the brain. These events can cause a variety of symptoms, including confusion, disorientation, jerking motions, or loss of consciousness.

Headaches

See pediatric primary care

Idiopathic intracranial hypertension

The spaces around the brain fill up with excess cerebrospinal fluid, putting pressure on the brain and the optic nerve. This can gradually lead to permanent vision loss if untreated. Symptoms include vision problems (such as double vision or blind spots), headaches, fatigue, nausea, and ringing in the ears (tinnitus).

Neurodegenerative diseases

This is a broad group of nervous system conditions that are degenerative and progressive, meaning that nerve tissue is gradually destroyed (and not replaced) over time. Symptoms vary depending on the type of nerve tissue affected but can involve cognitive, sensory, and/or motor control functions getting worse over time.

Sleep-wake regulation disorders

See pediatric pulmonology and sleep health

Spina bifida

Part of a newborn’s spine doesn’t fully close before they are born, which leaves part of their spinal cord exposed. Symptoms vary greatly depending on how much of the spinal cord is exposed.

Stroke

A sudden event when part of the brain is cut off from a normal supply of oxygen-rich blood, due to a blocked blood vessel (ischemic stroke) or brain bleeding (hemorrhagic stroke). If you notice your child has suddenly developed a severe headache, drooping face or limbs, is struggling to speak or understand words, call 911 immediately.

Tethered cord syndrome

In this condition, the spinal cord becomes attached to the surrounding spinal wall, limiting its ability to gently slide and move as needed. This can cause problems like poor blood flow, muscle weakness, numbness, and reduced motor control as a child grows.

We offer a wide range of treatment options for children with epilepsy. Our experts build personalized treatment plans that will be the most effective and least invasive for your child. Services include:

Dietary therapies

Your child may be able to reduce the frequency and severity of their seizures by following a personalized low-carb diet plan, such as keto or a modified Atkins diet. We can help you determine if this approach would be best for their overall health.

Medication management for refractory epilepsy

While many cases of epilepsy can be treated with conventional anti-seizure medications (anticonvulsants), some cases are (or eventually become) resistant to these drugs. If this occurs, there may be other forms of medication that will be more effective for your child. We can recommend alternative medications and dosages appropriate for your child’s age, development, overall health, and the cause of their seizures.

Neuromodulation therapies

These treatments control seizures by sending electrical impulses to the brain, which are generated by a small device implanted under the skin. Techniques include nerve stimulation (which sends signals to the brain at regular intervals) and responsive neuromodulation (which responds only when seizure activity is detected).

Surgical evaluation

If our team believes surgery is the best option, we will help the pediatric neurosurgery team determine the most appropriate approach, using a variety of advanced, non-invasive, and radiation-free brain scanning techniques.

Advanced brain imaging

We use a variety of imaging tools that help our doctors evaluate your child’s brain structure and function. This includes magnetoencephalography (MEG), an advanced scanning technology that can pinpoint unusual electrical activity in the brain down to the millimeter without using dyes or radiation. Other imaging tools include magnetic resonance imaging (MRI) and electroencephalography (EEG).

Gene therapy infusions

Doctors use a variety of techniques to provide children with a working copy of a gene that is missing or malfunctioning in their genetic code. This may help them manage symptoms or slow the progression of certain genetic conditions, such as spinal muscular atrophy (SMA) and Duchenne muscular dystrophy (DMD).

Neurogenetic evaluation and counseling

Our neurogenetics team studies the connection between genetics and nervous system disorders. We work to uncover any possible genetic causes or contributing factors to their condition, develop treatment plans, and help children and families understand their diagnosis and future risks.