As a neurogenetic counselor, Preeti T. Desaigoudar, LCGC, educates and supports families through the process of genetic testing and a possible genetic diagnosis. Since a diagnosis can affect many parts of the body, she will coordinate care among various specialties. “I function as a part of a team, working alongside a neurologist — I’m not…
The patient At age 10, the patient was diagnosed with a high-grade arteriovenous malformation and treated with radiosurgery. About six months later, the patient developed a severe case of brain swelling that left them with a right-sided spastic hemiparesis. A baclofen pump was placed in the normal abdominal/spinal position — to great effect. The challenge…
Tumors in the central nervous system (CNS) account for 20% of childhood cancers, with 5.65 cases and 0.72 deaths per 100,000 children under 14 in the United States. Brain tumors are second only to acute lymphoblastic leukemia in incidence. While recent advances have resulted in greater life expectancy for some childhood CNS tumor patients, the…
The patient A 14-year-old female presented with worsening headache and deterioration of vision especially in the left eye. MRI detected a large hypothalamic enhancing tumor causing mass effect on the optic nerves. The pituitary gland appeared to be pushed inferiorly. The challenge Because of tumor location and potential complications with tumor resection, the multidisciplinary team…
When children have headaches or experience migraine, it is usually not necessary to make a referral to a neurologist right away. Michael K. Sowell, M.D. and Elizabeth S. Doll, M.D., pediatric neurologists at Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine, share tips for how to begin treating a patient before making…
Most seizures in newborns and children stop on their own, usually within about three minutes. The longer a seizure goes, however, the less likely it is to stop without treatment. Children who have continuous seizures lasting longer than five minutes or who have two or more seizures with incomplete recovery between them have status epilepticus….
Medulloblastoma is one of the most common malignant brain tumors in children, with cases tending to surface around ages 4 or 5. Currently, the treatment protocol is resection of as much of the tumor as can be done safely, followed by concurrent radiation therapy and chemotherapy, according to Mustafa Barbour, M.D., pediatric hematologist/oncologist at Norton…
Not all headache or migraine symptoms in children signify red flags that require additional referrals or advanced treatment, said Elizabeth S. Doll, M.D., child neurologist at Norton Children’s Neuroscience Institute, affiliated with the UofL School of Medicine. “There are over 200 different types of headaches, but the majority of what we encounter in clinic are…
Anti-CD20 monoclonal antibody therapy represents a major advance in treating relapsing multiple sclerosis (MS) in adult patients, reducing relapse risk and mitigating disability progression. These monoclonal antibody therapies deplete circulating B cells by targeting CD20, a surface marker expressed on pre-B cells, naïve B cells and memory B cells. A review article in CNS Drugs,…
If a pediatric patient complains of headaches, primary care providers should inquire about their screen time habits. Spending too much time staring at a screen, such as a phone, tablet or computer, can cause digital eyestrain, a key trigger in pediatric headaches. The pandemic may exacerbate symptoms Symptoms of digital eyestrain include headaches, especially around…
Migraine is the most frequent primary headache disorder among the pediatric population, and while headaches in children can be complicated to treat and diagnose, there are several steps a primary care provider can take prior to referring the patient to a neurologist. Diagnostic steps for primary care providers The provider should work with the patient’s…
For two-thirds of children with epilepsy, medications are effective at reducing seizures. After trying two or more anti-seizure medications without success, the remaining one-third have medically refractory epilepsy. For these children, surgery, a ketogenic diet or implantation of a neuromodulation device are options. Determining which of these is best for a particular child requires a…