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

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

Febrile Seizures – Primary Steps for Primary Care


Febrile seizures are the most common seizure type in childhood, affecting 2-5 percent of children. These seizures are associated with a febrile illness in the absence of central nervous system infection or electrolyte imbalance, and they typically occur between the ages of 6 months and 5 years (peak 18 months). Most febrile seizures can be … Continue reading Febrile Seizures – Primary Steps for Primary Care

Tics – Primary Steps for Primary Care


Tics are repetitive, stereotyped, involuntary movements that usually begin in childhood. They can consist of motor and vocal tics, such as excessive eye blinking/rolling, facial grimacing, neck or shoulder jerks, sniffing, throat clearing or other vocalizations. Tics can be transient or chronic. If chronic, it may meet the criteria for Tourette syndrome. Tourette syndrome is … Continue reading Tics – Primary Steps for Primary Care

Concussion – Primary Steps for Primary Care


A concussion is a trauma-related pathophysiological process that affects the neurometabolic function of the brain. Concussions are quite prevalent; the CDC reports 3.8 million sport-related brain injuries occur annually. It is estimated in middle school and high school children, up to 20% of children have suffered a concussion. In the majority of patients, post-concussive symptoms … Continue reading Concussion – Primary Steps for Primary Care

Chiari I Malformations – Primary Steps for Primary Care


Anxiety related to unexpected abnormal findings disclosed by imaging studies obtained during workup of headache or trauma is a frequent reason for referral to neurosurgery. A frequent incidental imaging finding is a Chiari I malformation, i.e., the presence of low-lying cerebellar tonsils, usually unaccompanied by other significant imaging findings. While the estimated prevalence of Chiari malformations is … Continue reading Chiari I Malformations – Primary Steps for Primary Care