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?

Epilepsy is a neurological disease which is characterised by recurring epileptic seizures. These seizures can be brief or can persist for prolonged periods. Vigorous episodes which last long can result in physical injuries such as broken bones. Mention that 6th February is International epilepsy day.

Causes of Epilepsy
The cause of this condition isn t very evident; however, most medical practitioners attribute epileptic seizures to brain injury, tumours, infections in the brain or birth defects. Some doctors believe that epilepsy is caused due to genetic mutations and is an outcome of abnormal activity of cells in the brain. Other causes for this condition can be alcohol or narcotics withdrawal and electrolyte problems.

Symptoms

Repeated seizures
Impaired memory
Bouts of fainting
Short spans of blackout
Sudden bouts of blinking and chewing
Panic
Inappropriate repetitive movements
Types of Seizures
A seizure, also known as fit, is usually a brief episode characterised by uncontrollable jerking movement and loss of awareness due to abnormal neuronal activity in your brain. A collective occurrence of these seizures causes epilepsy.

There are three types of seizures an epileptic person usually encounters.

Idiopathic: This kind of seizure has no apparent cause
Cryptogenic: The doctors believe that there is a cause for the seizure but cannot detect it
Symptomatic: These seizures occur due to a reason.
Treatments

Medication: Medication is the most common treatment in case of epilepsy. Drugs taken on a regular basis can stop the seizure partially. But in very severe cases, they seem to have no effect at all.
Surgery: For symptomatic seizures which are caused due to abnormal brain function, surgery can be a way to get rid of seizures. In some minor cases, nerve stimulation in the brain and special diets can be prescribed to control the epileptic seizures.
Five facts about epilepsy you need to know:

Epilepsy is not psychosis or madness and can be treated easily 
Popular celebraties with epilepsy include Aristotle, Alfred Nobel, Alexander the great, Sir Isaacs Newton, Martin Luther and Julius Caesar etc. 
Woman with epilepsy can have a normal pregnancy 
Newer medicines for epilepsy are effective and very safe 
Surgery can cure epilepsy in some patients.

All You Need To Know About Epilepsy

Epilepsy is a form of chronic disorder and it is characterized by recurrent seizures. The episodes of epileptic seizures may differ from person to person. These seizures could be a result of a genetic disorder or a result of trauma or stroke. During a seizure, a patient may also experience symptoms of neurological disorders and sometimes lose consciousness.

Medical help for epilepsy
Epilepsy itself cannot be cured using medication, but proper medicines help in eliminating recurrent seizures. These medicines stabilize the electrical activity within the brain preventing seizures.

How effective is the medication for epilepsy?
The success of controlling seizures using medicines depends on the type and severity of epilepsy. Medicines for epilepsy are usually very effective and may fully keep seizures under control. However, controlling seizures caused due to brain problems may be more difficult. Usually, epilepsy medicines can control seizures for a long period of time when they are taken regularly.

When is medical help needed?
The decision about when to start medicines for epilepsy is a tricky one. This is because a first seizure cannot confirm whether a person has an on-going epilepsy problem. A second seizure may occur after many years or may not happen at all. Prediction of seizures is also quite difficult.

The severity of seizures also indicates when to start medicines for treatment. In case a first seizure is quite severe, medication should be started at once. Some people have very mild seizures even though they may be recurring in nature, and medication can be avoided in this situation.

The decision of starting medication will vary from case to case and in most cases, medications may be prudent after the first seizure itself. You should always consult a doctor to know when you need to start taking medicines to treat the condition.

For making the most out of the medicines to control seizures, you should follow certain steps:

You must take medications exactly as your doctor has prescribed.
Before switching to generic versions of your medicines or before taking other prescribed medicines, you must consult your doctor.
You should never stop taking the medicines.
In case you experience enhanced depression, mood swings and suicidal thoughts, you should talk to your doctor immediately.
In case you have the migraine, you should let your doctor know so that he can prescribe you anti-epileptic medicines, which also prevent migraines.
Medicines cannot treat the underlying cause of epilepsy, but these help in controlling seizures and this is the most common symptom of epilepsy. Medication should be started at a proper time and must be continued without stopping.

Epilepsy - When To Seek Medical Help?

Grading of brain cancer is entirely different as compared to the staging of other cancers in the body. Cancer in the breast, lung, colon etc. are staged depending on the possible spread, location of a tumor and lymph node involvement etc. However, brain tumors are graded based on the aggressiveness of the tumor cells under a microscope. The resect ability and the grade of the tumor cells guide a doctor on the treatment decisions. The decision of a brain surgery depends on factors such as the location, spread of a tumour and the general health of the patient.

Types of Brain Tumor Grading:

Grade 1 tumor- These sets of tumors are medically known as the juvenile pilocytic astrocytoma and subependymoma. They are slow growing and non-invasive. There is a likelihood of the patient getting cured with surgery.
Grade 2 tumor- These are brain tumors that do not possess dead cells as part of the tumour. But, they do portray a lot of abnormal cells. Tumors of this type can be categorized under oligodendroglioma, astrocytoma, and ependymoma.
Grade 3 tumor- Tumors of this type are graded based on the cell type of the cancer cells. For instance, an anaplastic astrocytoma is a grade 3 tumor that has no dead cells but possesses dividing cells. In contrast, anaplastic ependymoma and anaplastic oligodendroglioma are grade 3 tumor cells that have dead cells in them.
Grade 4 tumor- Tumors of this type are referred to as glioblastoma. The tumor cells are actively dividing, the growth of blood vessels is witnessed and areas of dead tissue keep expanding.

Treatment options:
Surgery- If the location of a brain tumor is such that it is accessible to a surgeon, the latter goes ahead and removes most of the tumor if not the whole. If, however, the brain tumor cells are placed very near to the surrounding very sensitive brain tissues, a doctor might remove a small portion of the tumor to curb its growth.
Radiation Therapy- This mode of treatment uses high energy X-ray beams to kill targeted cells of the brain. External beam radiation usually targets a small area of the brain. A whole brain radiation, on the other hand, is usually employed when a tumor has spread to most parts of the brain. Radiotherapy is now so evolved that it is highly targeted to tutor cells that kills cancer and spares normal brain .
Chemotherapy- Chemotherapy employs drugs to kill cancer cells. Chemotherapy can either be taken in the form of an IV or in the form of pills. The dosage of chemotherapy is decided based on the concentration of cancer cells, spread frequency, platelet count of the patient etc. The most common chemotherapy drug that is prescribed by doctors to fight cancer cells is temozolomide.

Brain Tumor - Stages and Treatment!

A neurological disorder characterized by sudden recurrent episodes of sensory disturbance, loss of consciousness, and convulsions associated with abnormal electrical activity in the brain.

Role of physiotherapy in epilepsy

It helps improve strength, mobility, and increases the range of motion and sphere of movement.

It helps improve sensory awareness, response, balance, and coordination.

It helps to improve quality of movement and physical performance.

The goals of physiotherapy

To develop strength enough to support one s head upright

To have balance and motor control to maintain their trunk at midline

To use many different muscle groups

To assist necessary motion in their trunk and extremities

The physiotherapists write short-term goals for each of the items on the problem list that need to be covered to help the patient achieve the long-term goals

To understand what the patient is good at and does well

To focus on what he or she capable of doing rather than on what they can t do

To educate and provide awareness with a view to prevent injuries

For example, advice on special swimming equipment to prevent drowning if he/she gets seizures in the pool

Padding out sharp corners in the house to prevent damage if fallen on

Physiotherapy treatment for a healed fracture consists of strengthening muscles that have got weak from being immobilized and stretching muscles that are stiff owing to being in the cast for a long period of time.

How can physical exercise help with seizures?

Physical exercise improves fitness, energy, and mood and even relieves stress. Improving overall health and well-being in this way can help reduce seizures. 

It can also help people feel more in control of their health. 
It also helps release  feel good  hormones into the brain, keeps muscles active, reduces fat levels in the body, and increases oxygen flow to the brain. 
It can also increase the bone density. 
A research showed that regular sessions of aerobic exercise (for example running, walking, swimming, cycling) for 60 minutes, twice a week, for 15 weeks can result in a significant reduction in the number of seizures they had.
Drink water, diluted fruit juice, or squash while exercising to help replace the fluids and body. Do not exercise straight after a meal.
Team sports or group activities such as walking or gardening groups can also be a good way of increasing self-confidence. 
Making new friends may help with any feelings of isolation. 
Most sports, including contact sports like football, hockey, basketball and rugby, have not shown to increase the chance of someone having a seizure, but contact sports come with an increased risk of head injuries, which could affect people with a history of epilepsy. Protective sports headgear helps to reduce this risk.


Epilepsy - Understanding The Role Of Physiotherapy In It!

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!

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