Neurodevelopmental disorders refer to any impairment and disorder of the brain and nervous system growth and development. Disorder in the brain and nervous system can affect the emotional, physiological, psychological ability and overall timely development of a child. With advanced technology and continuous study in the medical field, one can now assess the neurodevelopment of his/her children. Neurodevelopmental Assessment concentrates on the overall growth and development of a child including his/her weaknesses and strengths. A complete developmental profile is generated with the help of various tests and examinations. This assessment is used to analyse the various developmental factors including social and communication skills, functional and motor skills, cognition and learning abilities, and language and speech development. Neurodevelopmental Assessment involves a team of child s close people including parents, guardians, and family members who help to understand the medical history if any. It helps doctors to provide appropriate ways to assist the child in his/ her growth and development.

Tests and Examinations

Tests for the Neurodevelopmental Assessment may vary from child to child depending upon their condition. But, there are usually some tests that are done to understand the overall development of the child. These tests may include speech tests, hearing tests, blood tests, physical examinations, and questionnaires, which may be given before or during the assessment process.

Assessment

The assessment processes and sessions may vary depending upon the need of the child. However, usually, there are three major sessions that help the pediatrician understand the concerns of the family and parents. These sessions include consulting about the detailed medical history of the child, understanding the problem and its possible cause, and providing proper ways and treatment options for the patient. 

In the first session, parents and guardians are asked about any medical concern they have and the medical examination of the child is carried out accordingly. A standardized assessment with the child will be carried out by a clinical psychologist and the parents and guardians are asked to complete a questionnaire for the assessment. Depending upon the age, questionnaire may be sent to school for teacher/s to complete.

The next session is usually led by language and speech therapist to discuss and understand the current language and speech concerns of the child. Previous assessments and medical examinations are taken into account to carry out further assessments. An occupational therapist will assess the child s ability to perform self-care activities and other tasks according to his/her age. The session may include the assessment of a child s motor skills and abilities and reflection on any probable sensory-based problems that may be affecting the child s occupational performance.

The last session mainly includes the discussion with the parents and guardians to help them understand the problem, its causes, and treatment options. If the child requires any further assessment or/and recommendations, then the parents are told about that too.

Takeaway
Neurodevelopmental Assessment of children is often performed on kids who do not show the developmental signs according to their age. Parents and guardians should not hesitate to consult their children to clinical psychologist and therapist as the early intervention and assessment can help in the timely growth and development of the children.

Neurodevelopmental Assessment (0-5 Years)  - What Should You Know?

Injuries are very common, especially head injuries are one of the leading causes of death and disability in adults. As per surveys conducted, 1.7 million people suffer from head injuries every year and this estimation is increasing day by day.

Head Injury is any trauma to head other than superficial injuries to face. It results in high morbidity & mortality. Head injuries are an important cause of loss of young people at their productive age.

Causes of Head Injury-

A head injury can occur due to many reasons. Some common causes of these head injuries are:

Vehicle accidents

Street fights

Fall from height

Child abuse

Symptoms of Head Injury-

A head injury is followed by various symptoms depending upon the intensity of the injury. Here is a list of the possible symptoms of brain injuries:  

Nausea and vomiting, fatigue or sleepiness, severe headache, confusion, amnesia,  loss of consciousness, seizures, loss of muscle control or paralysis in the part of the body controlled by the part of the brain that is affected, coma, dilation of the pupils and disturbance of vision, Cerebrospinal fluids might come out of the ears and nose, sometimes accompanied by blood, difficulty in breathing, low pulse rate, increase in blood pressure, difficulty in swallowing, loss of hearing, problems in cognitive functions.

Brain damage is a process, not an event. 80% are minor head injuries, 10% are moderate head injuries and 10% are major head injuries.

Management of Head Injury-

Diagnosis of a brain injury has to be detailed and very quick at the same time. It always comes under emergency cases. Some of the steps involved are:

Glasgow Coma Scale

Pupillary reaction to light

Brain stem reflex tests

Head to toe examination

CT scan of head is the initial study of choice. MRI Brain is helpful in cases of non-haemorrhagic contusions, diffuse axonal injury and deep lesions.

Surgical Indications

Head injuries with intracranial hematomas causing significant mass effect

Massive cerebral edema

Hydrocephalus

Infection

Precautions for Head Injury

Use Helmets- both riders

Use Seat Belts

Keep vehicle speed under control

Follow traffic rules

Take adequate precautions during trekking, diving

Take Away-

No head injury is minor enough to be neglected nor severe enough to be given up.

Head injuries take time to heal, but medical treatment along with neurosurgery can aid the process of recovery and also help a person to lead a healthy life in the future. Most young patients recover fully, while some older patients or patients with preexisting neurological conditions live with a degree of disability.



Head Injuries - All You Must Know!

Headaches and migraines can vary drastically depending on their duration, specific symptoms and the person they are affecting. The more you know about your specific type of headache or migraine, the better prepared you will be to treat them and possibly even prevent them. The two types of migraine are- 

Migraine without aura: The majority of migraine sufferers have Migraine without Aura. 
Migraine with aura: Migraine with Aura refers to a range of neurological disturbances that occur before the headache begins, usually lasting about 20-60 minutes.
Symptoms of migraine vary and also depend on the type of migraine. A migraine has four stages: prodrome, aura, headache and postdrome. But it is not necessary that all the migraine sufferers experience all the four stages.

Prodrome: The signs of this begin to appear a day or two days before the headache starts. The signs include depression, constipation, food cravings, irritability, uncontrollable yawning, neck stiffness and hyperactivity.
Migraine Aura: Auras are a range of symptoms of the central nervous system. These might occur much before or during the migraine, but most people get a migraine without an aura. Auras usually begin gradually and increase in intensity. They last for an hour or even longer and are 

Visual: Seeing bright spots, various shapes, experiencing vision loss, and flashes of light
Sensory: Present in the form of touch sensations like feeling of pins and needles in the arms and legs
Motor: Usually related with the movement problems like the limb weakness
Verbal: It is related with the speech problems
Headache: In case of a migraine attack one might experience:

Pain on both sides or one side of the head
Pain is throbbing in nature
Vomiting and nausea
Sensitivity to smells, sound and light
Vision is blurred
Fainting and lightheadedness
Postdrome: This is the final phase of the migraine. During this phase one might feel fatigued, though some people feel euphoric.

Red flags that the patient may be having underlying serious disorder not migraine

Onset of headaches >50 years 
Thunderclap headache - subarachnoid haemorrhage 
Neurological symptoms or signs 
Meningism 
Immunosuppression or malignancy 
Red eye and haloes around lights - acute angle closure glaucoma 
Worsening symptoms 
Symptoms of temporal arteritis
These patients require CT scan / MRI or CSF examination. Most Migraine patients do not need these tests. 

Diagnosis of Migraine: Usually migraines go undiagnosed and thus are untreated. In case you experience the symptoms regularly then talk to the doctor, who evaluates the symptoms and can start a treatment. You can also be referred to a neurologist who is trained to treat the migraines and other conditions. During the appointment the neurologist usually asks about the family history of headaches and migraines along with your symptoms and medical history.

The doctor might advise for some tests like:

Blood Tests: These reveal problems with the blood vessel like an infection in the spinal cord and brain.
CT scan: Used to diagnose the infections, tumors, brain damage, and bleeding that cause the migraines.
MRI: This helps to diagnose the tumors bleeding infections, neurological conditions, and strokes.
Lumbar Puncture: For analyzing infections and neurological damages. In lumbar puncture a thin needle is inserted between the two vertebrae to remove a sample of the cerebrospinal fluid for analysis.
Treatments

Migraine treatments can help stop symptoms and prevent future attacks.

Many medications have been designed to treat migraines. Some drugs often used to treat other conditions also may help relieve or prevent migraines. Medications used to combat migraines fall into two broad categories:

Pain-relieving medications. Also known as acute or abortive treatment, these types of drugs are taken during migraine attacks and are designed to stop symptoms.
Preventive medications. These types of drugs are taken regularly, often on a daily basis, to reduce the severity or frequency of migraines.
Your treatment strategy depends on the frequency and severity of your headaches, the degree of disability your headaches cause, and your other medical conditions.

Some medications aren't recommended if you're pregnant or breast-feeding. Some medications aren't given to children. Your doctor can help find the right medication for you.

Migraine - Identifying the Early Signs!

Brain tumor refers to the development of unusual cells in the brain or around the nearby tissues and structures. Pediatric Brain Tumor means the development of these unusual cells in the brain of children. There are two types of brain tumors: Benign or non-cancerous and malignant or Cancerous. Tumors like ependymoma and medulloblastoma are quite common among children. The treatment of the tumor is determined by its severity, type, location, age, and overall health of the child. The treatment of Brain Tumor in children is different from the adult s treatment. One should ensure to consult with the pediatrician with the specialty in cancer and neurology. Brain Tumors in children are Primary Brain Tumors that develop in the brain or nearby tissues. This Primary Brain Tumor develops when the usual cells have DNA mutations or alterations. The alterations in the DNA permit the cells to develop and distribute or split with an increased rate and destroy the healthy cells. This leads to the development and collection of unusual cells forming a tumor. In most Primary Brain Tumor cases, the cause is not clear. Children with a family history of the genetic syndrome and Brain Tumor are more prone to the problem.

Symptoms-

The symptoms of the Pediatric Brain Tumor depend upon the severity, location, and type. There are a number of symptoms that are really common and are shared by other diseases. Other than this, there are symptoms which are possibly the signs of Brain Tumor among children. Adults and parents should consult a doctor if they find their children having the symptoms and signs for an unusual time.

Hearing issues

Frequent and severe headache

Fuller fontanel (soft spot) on the baby s skull

Vomiting or nausea

Behavior changes

Seizures

Sudden vision problems like double vision

Abnormal or strange eye movement

Increased heaviness or pressure in the head

Irritability

Slurred speech

Difficulty in swallowing

Weakness

Loss of appetite

Drooping on one side of the face

Difficulty feeding in babies

Loss of sensation on one side of the body

Imbalance or difficulty in balancing

Difficulty in walking

Diagnosis-

The diagnosis for the Pediatric Brain Tumor includes many lab tests. The doctor may initiate with some neurological examination like hearing, vision, reflexes, balance, and coordination. Any abnormality in these tests will lead to further examinations. There are some imaging tests that are used to determine the size and location of the tumor in the brain. These tests include MRI (Magnetic Resonance Imaging), PET (Positron Emission Tomography), and CT (Computerized Tomography). After the confirmation of the presence of a Brain Tumor, the specialist will further move to the Biopsy. It includes the removal of a sample tissue for analysis or testing. The type of biopsy that will be performed on the patient depends upon the location of the tumor. Other than the biopsy, the tumor tissue can be examined for molecular basis and genetic mutations. After that, Drug therapy can be designed according to the individual s requirements. It is important for the doctor and the patient to know if the tumor has been spread through cancer in other parts of the body. If it is true, then the doctor will perform more tests and examinations to know the root and initial location of cancer for further treatment.

Treatment-

The treatment of the Pediatric Brain Tumor is determined by the severity, location, size of the tumor, and age and health of the child. There is a number of treatments available with modern technology but their usage depends upon the patient s requirement.

Surgery that is used when the location of the tumor is approachable via surgery. When the brain tumor is small, it can be completely removed by the surgery. But when the tumor tissues are located nearby sensitive areas of the brain, then the surgery becomes risky and maximum tumor tissues are tried to be removed through surgery. The risk of the surgery depends upon the location of the tumor. An example can be vision loss if it is anywhere near the nerves connected to the eyes.

Targeted Drug Therapy helps to destroy the abnormalities of the cancer cells resulting in the destruction of the cancer cells.

Radiation therapy is used to kill the tumor cells by using high-energy beams. Radiation therapy can either be given by an external machine (external beam radiation) or in exceptional cases, radiation is positioned within the body (brachytherapy) near the tumor.

Chemotherapy includes the consumption of drugs to destroy the tumor cells. These drugs can be consumed in tablet form but for children, the drugs are mostly injected (intravenous chemotherapy).

Stereotactic Radio Surgery includes various radiation beams to perform extremely focused radiation therapy to destroy the tumor cells located in a small part.

Proton Beam Therapy carries higher targeted radiation doses to the tumor cells with minimum exposure of radiation to the healthy cells and tissues. It decreases the chance of development of fresh cancer cells.

Take Away-

Pediatric Brain Tumor is the development of unusual cells in the brain or around it. Although this is a life-threatening problem, however, with advanced technology, it can be treated successfully. There are no specific causes discovered by specialists but genetic mutations and family history cause it. The symptoms can be really common like headache and nausea but can also be specific like difficulty in coordination, reflexes, speech, and many more. The timely diagnosis and treatment can give a new life to the child and reduces the chance of development of fresh tumor cells in the future.

Pediatric Brain Tumor - Know In Detail About It!

Nobody knows the exact cause of autism. All medical science knows is that it s a complex neurological disorder which is detected within the first three years of life and is caused due to structural changes in the brain. Autism causes a number of symptoms which grade from mild to moderate to severe, like-

Difficulty in communication and social interaction
Language impairment
Preoccupation with fantasies
Repetitive acts (echolalia)
Excessive possessiveness to certain objects
Intellectual impairment
Over-sensitivity or under-sensitivity to pain
Developmental problems
Causes
Genetic predisposition is the most common cause of autism. Exposure to environmental toxins is the other. Other causes are use of certain drugs during pregnancy, vaccinations etc.

Diagnosis
Diagnosis of autism can only be done by clinical evaluation as there are no laboratory tests for it. The psychiatrist prepares a detailed developmental case history of the child before arriving at a diagnosis.
There are a number of Autism screening tests to diagnose autism as well. One thing to always follow is to go to a psychologist who has a history of treatment of autistic disorders.

Diet
Theories are emerging that autism may be caused by a super sensitive child s response to foods like gluten found in grains and casein, a protein found in milk. These transform into substances that act like opiates in the child s body.

These drug-like substances alter the child s behaviour, his perceptions, and his responses to his environment. Recent research has found chemicals with opiate activity in the urine of a significant number of children with autism.

Autistic children have shown mild to dramatic improvements in speech, behaviour after going on a gluten-free, casein-free (GFCF) diet.

Some of the foods that can be eaten on GFCF diet include rice, quinoa, potato, buckwheat flour, soy, amaranth, corn, fruits, vegetables, beans, tapioca, meat, poultry, fish, shellfish, nuts, eggs, and sorghum, among others.

Homoeopathic treatment of Autism:

The homoeopath carries out a detailed study of the family history of serious diseases which are linked to the development of autism in his patient.
The genetic evaluation of the patient is followed by case analysis which takes into account impaired functions in the patient like repetitive behaviour, lack of social skills, speech issues etc.
The homoeopathic medicines indicated for autism are twenty and are usually given in combinations. A homoeopath takes the decision about the exact medicine to be given, its combination with other support medicines, the dose and its repetition based on the case history of the child.
By no means should one try to cure autism by self-medicating on homoeopathic medicines as this can cause deleterious effects.
It usually takes a minimum of six months for some perceptible changes in autistic children. Homoeopathic treatment may have to be continued for over a year if the symptoms of autism are very severe.

Autism- Diagnosis, Diet And Homeopathic Treatment!

Epilepsy is a disorder in the central nervous system characterized by recurrent seizures. An unexpected rush of electrical activity inside the brain leads to a seizure. Brain activity becomes abnormal and leads to periods of unusual behaviour with loss of awareness at times.

Seizures do not always include unusual muscle movements or convulsions. Untreated seizures can seriously affect the lives of children having them. Epilepsy affects both men and women regardless of their ethnic background and age.

Signs of Epilepsy:

A staring spell
Momentary bewilderment
Loss of consciousness
Jerking movements of arms and legs.
Panic or anxiety
Kinds of Seizures:
Seizures are normally classified as focal or generalized depending on the commencement of abnormal brain activity.

Focal (partial) seizures result from abnormal activity in a particular area of the person's brain. Simple partial seizures may change emotions or the way things smell, appear, feel, sound or taste. It is characterized by tingling and dizziness.
Complex partial seizures or focal seizures with impaired awareness entail a modification of or loss of awareness and consciousness. Repetitive movements are performed during such seizures such as hand rubbing, walking in circles or swallowing.
Thorough testing is needed to differentiate epilepsy from other neurological disorders such as narcolepsy, migraine or mental illness.

Generalized seizures normally affect all areas of the brain and consist of:

Tonic seizures lead to muscle stiffness and normally affects muscles in the person's back, legs and arms.
Atonic seizures or drop seizures lead to a loss of muscle control which makes a person abruptly collapse or fall down.
Myoclonic seizures are visible as short jerks or twitches of a person's arms and legs.
Clonic seizures are characterized by repetitive or rhythmic jerking muscle movements.
Tonic-clonic seizures cause sudden loss of consciousness, quivering and body stiffening.
Absence seizures might take place in clusters and lead to momentary loss of awareness.
Symptoms of Epilepsy:
The main symptoms of epilepsy are seizures and it differs from one person to another.

Symptoms of Focal (partial) seizures include:

Dizziness
Change or modification in the sense of smell, taste, hearing, sight or touch.
Twitching and tingling of limbs.
Symptoms of Complex partial seizures include:

Unresponsiveness
Staring blankly
Performing repetitive movements
Loss of awareness or consciousness
Genetics may provide a person with a natural seizure threshold as a person who is susceptible to seizure triggers is said to have inherited a low seizure threshold. A higher threshold conversely makes a person less liable to have seizures.

Epilepsy is a comparatively common neurological disorder that affects innumerable people worldwide and treatments range from medication to surgery.

Epilepsy - Signs and Symptoms You Must Know!

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