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?

Cerebral palsy is the term for a group of neurological disorders that affects one s muscle movement and motor skills.

In most cases, the condition is caused due to a brain impairment that develops while the baby is still in the womb. Cerebral palsy may also occur shortly after or during birth.

Symptoms of Cerebral Palsy:

The signs and symptoms of the condition vary from one individual to another, ranging from mild to severe. The commonly observed ones in children are-

  Difficulty walking
  Difficulty holding on to objects
  Delay in developing motor skills- sitting up straight, rolling over, crawling
  Variation in the muscle tone- too stiff or too floppy
  Delay in development of speech
  Spasticity
  Lack of coordination of the muscles
  Difficulty swallowing and excessive drooling
  Functioning of only one side of the body
  Neurological ailments such as intellectual disabilities, seizures, and others

Types of Cerebral Palsy:

Cerebral palsy can occur in the following forms-

  Spastic cerebral palsy - Causes exaggerated reflexes and muscle stiffness. This is the most common type of cerebral palsy, affecting nearly 80% of the population.
  Dyskinetic cerebral palsy - Causes abnormal, involuntary movement of the legs, arms, and hands. It may also affect the movement of the tongue and face, thereby making it difficult to talk or swallow.
  Hypotonic cerebral palsy - Causes overly relaxed muscles and reduces muscle tone. The legs and arms are easily moveable and appear saggy.
  Ataxic cerebral palsy - This is the least common type. People living with this form of the condition have problems with coordination and balance.

Diagnosis and treatment of cerebral palsy

Cerebral palsy can be diagnosed with the help of the following-

  CT scan
  MRI
  Ultrasound
  Electroencephalogram

Treatment of the condition depends on its severity. Long-term treatment includes physiotherapy, medications and surgery.

  Physiotherapy and occupational therapy helps restore muscle strength and improves muscle tone. You can try stretching exercises to improve flexibility.
  Usually, the doctor prescribes medications in the form of muscle relaxants and sedatives. Muscle relaxants reduce muscle tension, helps relieve discomfort and muscle pain.
  You may need to undergo an orthopaedic surgery in case medications and therapy does not yield positive results. The surgery will aim to release tight muscles and repair bone abnormalities caused due to spasticity.

The specialist as a last resort may recommend SDR or Selective Dorsal Rhizotomy to reduce spasticity and chronic pain. This involves operating the nerves at the base of your spinal column.

There is no permanent cure for cerebral palsy. However, the condition is manageable with the help of drugs, therapy and surgery. The kind of treatment required depends on your overall condition. While some may be able to live with the condition without much assistance, others may require immediate medical intervention. Therefore, it is best to consult an orthopaedic and get help if the symptoms deteriorate over time.

Cerebral Palsy - Symptoms, Types & Treatment Of It!

Surgery to remove abnormal growths of the brain, peripheral nervous system or the spine or any disorder can be tricky because the brain and the skull that shields it are complex areas. In the old days, open surgery was the only way to access the brain or spinal cord. But, with the invention of laparoscopy, keyhole surgery to treat neurological issues is gaining ground.

What is Neuroendoscopy? 
Neuroendoscopy is a surgical procedure that is favoured by doctors and patients alike because it is minimally invasive.
Before the surgery, you will be administered general anaesthesia so that you will be unconscious during the entire duration. During the surgery, the surgeon will drill a minute hole into your skull just above the eyebrows. You skull also has two natural openings. That is why the surgeon may make use of the nose or the mouth to access the region that needs to be operated upon.

Neuroendoscopy is useful because -

  It lets the surgeon reach regions that are not accessible with open surgery
  The tumour can be removed without any damage being done to surrounding tissues

An endoscope is a delicate device with a high-resolution camera mounted on it. There is an eyepiece on the other end. The device is also fitted with a light. When it is inserted into the brain, it lights up the passage and the eyepiece allows the surgeon to take a look inside. The camera sends a live feed of the path it is traversing and this guides the surgeon. When the tumour is reached, it is gently removed with other surgical instruments that too were inserted through the cavities or the drilled hole.

Benefits of Neuroscopy -
There are several advantages of relying on laparoscopy -

  The patient endures less pain
  Fewer chances of infection
  Faster recovery
  Very little scarring of tissues

Which Disorders call for Neuroendoscopy?
Any of the following disorders can be put to rights with a neuroendoscopic surgery -

  Pituitary tumours
  Rathke s cleft cysts
  Pineal area tumours
  Ventricular tumours
  Skull base tumours
  Brain inflammation triggered by an infection
  Chordomas
  Cerebrospinal fluid fistulas
  Trigeminal neuralgia
  Cerebral aneurysm

After Surgery-
Once you undergo the neuroendoscopic surgery, you will have to be rehabilitated so that your condition can be monitored round the clock. Neuroendoscopy is a state of the art clean and efficient surgery that is beneficial to both surgeons as well as the patients.

Know More About Neuroendoscopy And Its Uses!

Study of the brain has fascinated specialists all over the globe since time immemorial. The brain being the most vital organ for survival and coordination is perhaps the most complex of them all too. This has led to a limited understanding of its working in spite of the available advanced technology. However, with the advent of techniques for diagnosis and treatment, therapeutic strategies are evolving. This is a major step towards rendering Neurosurgery safer than ever in the history of mankind.

Neurosurgery through the 20th Century-

During the beginning of the 20th century, Neurosurgery was considered as a specialty. The clinical-neurologist would draw conclusions related to lesions in the brain through neurological examination and clinical history. It enabled diagnosis of vascular lesions, spinal disorders, and brain tumors. During the second and third decades of the 20th century, vascular pathologies and brain tumors could be diagnosed indirectly through techniques like angiography, ventriculography, and pneumoencephalography. But since the operative techniques were too crude and the lack of skilled professionals were rampant, there were high rates of morbidity and mortality due to neurological conditions. Generally, after diagnosing the nature of brain lesion and its site, surgery was performed with inadequate maintenance and control of intracranial pressure and through not too sophisticated surgical instruments.

During the fifth and sixth decades of the 20th century, chemotherapy and radiation treatment came into the picture for treating malignant brain tumors, thereby reducing mortality to a good extent.

During the seventh decade of the 20th century, Computed Tomography (CT) scan provided a better understanding of the location of lesions in the brain which slightly substantiated the earlier techniques. Then, the procedures for cerebrospinal fluid diversion significantly improved management of intracranial pressure during surgery.

It was only during the last decade of the 20th century that the Neurology saw a giant progressive leap through the introduction of Magnetic Resonance Imaging (MRI) and powerful high magnification microscopes. Combined with Neuroanesthesia and Intracranial Pressure Management, this aided surgeons to work on a relaxed brain. This promoted safe removal of the brain tumor and better management of vascular lesions. Moreover, the understanding of micro-surgical anatomy improved drastically, leading to a boost in confidence levels of the micro-neurosurgeons performing the operation.

Neurosurgery in the 21st Century-

The 21st century is actually a revolutionary era that uses powerful computers in almost all the fields possible. Computer-based applications such as Neuro-imaging, Neuronavigation, Intra-operative Neuro-monitoring, and Neuro-modulation are now used in standard neurosurgical practice as a part of the routine. Extremely powerful CT scans and MRIs are used for diagnosis before surgery. The advent of nanotechnology and its application in Neurosurgery is doing great and has a promising future ahead based on the current study of scenarios. Moreover, there is a possibility of most of the Neurosurgical procedures becoming minimally invasive. Frameless Stereotaxy is another technique that helps in locating the exact position of the tumor, which further helps the neurosurgeon in navigating with great precision the very sensitive, high-risk areas of the brain. Such techniques, to a great extent, have lowered mortality and morbidity, lessened the rate of recovery, and chances of infection related to Neurosurgery.

Take Away-

A number of techniques for diagnosis and precise location of the tumor in the brain have made Neurosurgery much safer today, due to advancement in science and technology, than it ever had been in the history of mankind.

Advancements In Neurosurgery - Know How Safe It Is!

How Physiotherapy Can Help with Neurological Disorders

Neurological disorders are problems with any one or a combination of the central nervous system or any of its peripheral systems such as cranial nerves, neuromuscular junctions, and the autonomic nervous systems among others.

Some extreme examples of neurological disorders are:

- Dementia
- Alzheimer's disease
- Parkinson's disease
- Epilepsy
- Disorders brought on by strokes
- Multiple sclerosis and others

What is physiotherapy and how can it help?

Physiotherapy is a form of treatment where practitioners use physical forms of treatment such as massages, exercises, heat treatment and other controlled forms of external stimuli to treat physical disorders.

This method of treatment can be very effective in correcting neurological disorders.

Some of the physiotherapy techniques, which can be implemented to help patients, are as follows:

Electrical Stimulation: This method is commonly used to treat muscular problems, especially incurred after an accident or any other form of injury. In this method, controlled electric stimulation is given to specific nerve areas over the skin to stimulate them.

Heat treatment: This method involves applying heat to parts of the body such as joints or muscles where there is nerve or muscular damage. This treatment is especially effective for muscle related problems.

Ice or cold treatment: Vertically opposite to the principle of heat treatment, ice or cold treatment is used to contract muscles within the body. This is especially effective where inflammation needs to be controlled.

Manual therapy: Possibly the most common form of physiotherapy, this method employs massages, pressure points, stretching and hands on strengthening exercises and helps regularize nerve impulses to areas where they have been affected.



How Physiotherapy Can Help with Neurological Disorders

Acoustic vestibular schwannoma or the acoustic neuroma is a kind of tumour. But this tumour is benign which means it is non-cancerous. The vestibular nerve connects your ear to your brain, it is responsible for hearing and balancing. An acoustic neuroma develops on the vestibular nerve. And it can cause hearing impairment.

How does acoustic Vestibular Schwannoma occur? 
The vestibular nerve is lined with Schwann cells. Sometimes, these cells start to develop rapidly. This forms a mound on the nerve, it slowly becomes large enough to prod against the brain, and this adversely affects the actions of the brain.

What are the Symptoms?
In the early phases, the tumour does not trigger any symptoms. They begin to manifest once the tumour starts expanding. Here is a list of the symptoms of acoustic vestibular schwannoma-
  Gradual hearing loss
  Misalignment and losing balance
  Ringing in the ears.
  Regions of numbness in your face
Even though these tumours are benign, sometimes they enlarge to such an extent that they can be harmful to the brain. As soon as you witness the above-mentioned symptoms, book an appointment with a doctor.
With timely treatment and medication, doctors can reverse the growth of an acoustic vestibular schwannoma. 

What triggers this Disease?
The exact cause of this disease is not known. It could be any one of the following-
  A chromosomal anomaly or a malfunctioning gene
  Inhibition in the function of the protein suppressor that regulates the growth of Schwann cells

How is Acoustic Vestibular Schwannoma detected?
Your doctor will recommend these tests-

  Audiometry -
The audiologist will present sounds at different frequencies and you will have to make a gesture whenever you hear a sound. This will reveal the state of your hearing.

  Magnetic Resonance Imaging -
An MRI can detect the presence of a tumour that is 1-2 mms in diameter. If MRI causes pain or discomfort, a CT scan will be done.

Treatment -
If the tumour is tiny, your doctor won t prescribe medicines but your tumour will be monitored and imaged regularly so that the proper action can be taken as soon as it begins to enlarge.

  Surgery -
If the tumour is large, then you might have to undergo surgery. Not only will the tumour be removed, but also care will be taken to preserve the facial nerve so that facial paralysis does not set in.
You will be placed under general anaesthesia. The surgeon will drill a small hole in your skull near the ears and extract the tumour through your inner ears.

  Radiation -
If the tumour is small or if the patient is elderly and surgery can cause complications, doctors suggest radiation therapy. In this therapy, gamma rays are directed towards the tumour to shrink it.
Acoustic vestibular schwannoma can be treated if diagnosed on time. So, if you have noticed any symptoms, talk to a doctor right away.

Acoustic Vestibular Schwannoma - All You Must Know About It!

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