Infantile Spasms – Primary Steps for Primary Care


A type of severe seizure, infantile spasms require urgent evaluation and treatment. Unfortunately, the diagnosis of infantile spasms is too often delayed because they may be subtle, go unrecognized, or be misdiagnosed as some other less serious condition (i.e., reflux). When associated with an electroencephalography (EEG) pattern of hypsarrhythmia (Figure 1), this is known as … Continue reading Infantile Spasms – Primary Steps for Primary Care

Torticollis – Primary Steps for Primary Care


Torticollis is characterized by a lateral head tilt with the chin rotated in the opposite direction. It can be caused by many conditions, most commonly as a result of congenital asymmetry in the lengths of the sternocleidomastoid (SCM) muscles. Torticollis occurs in approximately 0.3-1.9% of all live births, more frequently in males, and most commonly … Continue reading Torticollis – Primary Steps for Primary Care

Renewed Hope: Novel Treatments for Spinal Muscular Atrophy Improving Outcomes


Spinal muscular atrophy (SMA) is a rare autosomal recessive neuromuscular disease that presents as progressive muscle weakness secondary to loss of lower motor neurons in the brainstem and spinal cord. With an incidence of 1 in 10,000 live births, SMA is the most common genetic cause of death in infancy, but new treatments may soon … Continue reading Renewed Hope: Novel Treatments for Spinal Muscular Atrophy Improving Outcomes

Complementary and Alternative Therapies for Migraine Treatment


Migraine is a common reason for referral to pediatric neurology. Very often, lifestyle modifications such as improved sleep, regular exercise, adequate hydration and avoidance of migraine triggers can reduce the frequency of migraines. For some, despite these measures, migraines continue to occur many times per month and require further treatment. One approach to treatment includes … Continue reading Complementary and Alternative Therapies for Migraine Treatment

Avoiding Medication Overuse Headache – Primary Steps for Primary Care


Headaches are a common complaint to primary care offices. In children, headaches are frequently transient, related to concurrent illness, inadequate hydration, or other common lifestyle factors. Commonly, over-the-counter treatments (i.e. NSAIDs) are recommended for the treatment of acute headache. While this is often effective, for patients with more frequent headaches – the repeated use of … Continue reading Avoiding Medication Overuse Headache – Primary Steps for Primary Care

Testing for Success – Primary Steps for Primary Care


Hearing the word “neuropsychological” can make any child feel confused and scared. The idea of testing may also bring up unpleasant associations with school tests or painful shots. At Cook Children’s, our program is developed with kids in mind. Tests are introduced as “games,” and most children find them fun and entertaining. Pediatric neuropsychologists are … Continue reading Testing for Success – Primary Steps for Primary Care

Toe Walking – Primary Steps for Primary Care


Toe walking is one of the most common reasons for a primary care evaluation of abnormal gait. Neurologic etiologies of toe walking are common and most concerning for both parents and their doctors. There may be clues in the patient’s history or physical examination that can help the primary care provider in giving reassurance as … Continue reading Toe Walking – Primary Steps for Primary Care

Transitioning to Adult Neurology Care


While “Primary Steps” articles are often written for primary care providers, some subjects are equally valuable to patients, their families and their speciality providers. Moving from a pediatric care provider to an adult care provider is likely to be very challenging for many patients – particularly those with special needs. Youth with neurologic conditions and … Continue reading Transitioning to Adult Neurology Care

Staring Spells – Primary Steps for Primary Care


Staring spells is a common chief complaint in pediatrics often noted by parents or teachers prompting evaluation. While absence seizures are certainly on the differential, staring can be many other things and careful history and evaluation is needed to guide evaluation and management. What is the differential of staring spells? Often times staring events in … Continue reading Staring Spells – Primary Steps for Primary Care

Headaches – Primary Steps for Primary Care


The start of the school year is just around the corner, and we frequently see an increase in calls regarding headaches around this time. We want to take this opportunity to review some basic steps in diagnosing and treating headaches. Nearly 10 percent of children have frequent or recurrent headaches. While this is a significant … Continue reading Headaches – Primary Steps for Primary Care