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!

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?

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!

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 neuroma is the development of noncancerous and slow-growing tumors on the main, vestibular nerve that travels from the inner ear to the brain, connecting the two organs. They are also known as vestibular schwannoma, as it arises from Schwann cells covering the vestibular nerve. It rarely grows rapidly or attains a large enough size that can press against the brain and interfere with the vital functions of the brain. Since the tumor is benign, the patient can be assured that it won t spread to the other parts of the body; however, they can grow large enough to disrupt the normal function of the body.

The pressure from the acoustic neuroma on the main nerve can cause loss of hearing, a constant ringing in the ear and unsteadiness. As per a report published by the Acoustic Neuroma Association, 1 out of every 50,000 people suffers from this condition.

Risk factors for acoustic neuroma
Acoustic neuroma does not have quite as many risk factors. The only established risk factor for acoustic neuroma is having a parent who suffers from the rare genetic disorder neurofibromatosis 2 (NF2). However, having said that, neurofibromatosis 2 (NF2) accounts for only 5 percent of the reported cases. In most of the cases, it has been found that the tumors appear spontaneously without any indication of a family member having this disease or any medical history of the same.

The development of noncancerous tumors on the ear nerves as well as other nerves in the body is scientifically supported as a characteristic indication of neurofibromatosis 2 (NF2). Neurofibromatosis 2 (NF2) is also termed as an autosomal dominant disorder, which indicates that the mutated gene can pass from just one parent. Each of the children has a fifty-fifty chance of inheriting the disease.

However, scientists and doctors have failed to identify why specific people get these tumors. They have reached a generic conclusion about the risk factors, which may include:

Loud noises near the ear.
A parathyroid neuroma, which is a similar benign tumor of the thyroid.
A chance of exposure to low levels of radiation in the childhood.
How to diagnose the risk factors for acoustic neuroma?
If you are experiencing loss of hearing or other neurological symptoms, try to keep track of them. Later on, mention them to your doctor for a proper diagnosis. A detailed history of the symptoms will help your doctor. Your doctor will perform a hearing test to check whether you have an acoustic neuroma. Then the doctor may perform a brainstem auditory evoked response tests along with an electronystagmography to detect any changes in eye movement, caused due to the inner ear. MRI and CT scans are also quite common diagnoses methods for acoustic neuroma.

Acoustic Neuroma - What Are The Risk Factors?

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!

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