Primary steps: The value of electroencephalography (EEG) in epilepsy


Scalp EEG is an electrophysiological tool that examines the electrical activity of the human brain. EEG is commonly ordered as part of the evaluation of “spells” or suspected seizures in children, and is a useful study that can guide the diagnosis of epilepsy and direct medication management. In patients with known epilepsy, EEG can help … Continue reading Primary steps: The value of electroencephalography (EEG) in epilepsy

Primary steps: Assessing abnormal movements in childhood


Abnormal movements in pediatric patients can be challenging to characterize, and it can be difficult to determine when one should be concerned. Babies and children do lots of funny things, but knowing when to move forward with a diagnostic workup of abnormal movement can be confusing. There are many different types of hyperkinetic movements including … Continue reading Primary steps: Assessing abnormal movements in childhood

Primary Steps for Primary Care: Evaluation and behavior management in children with developmental and/or cognitive delays


Management of behavioral problems in children can be challenging, particularly in those with developmental or cognitive delays. In these cases, determining the source of adverse behaviors and developing a treatment plan appropriate for the abilities of the child can be barriers to successful treatment. In this article,Lisa Elliott, Ph.D. discusses the evaluation and management of … Continue reading Primary Steps for Primary Care: Evaluation and behavior management in children with developmental and/or cognitive delays

Primary steps for primary care: Tuberous sclerosis complex (TSC)


TSC is an autosomal dominant neurocutaneous disorder affecting one in every 6,000-10,000 people. TSC manifests with multi-organ involvement including the skin, central nervous system, heart, lungs, eyes and kidneys. The most common identified cause is a variant in the tumor suppressor genes TSC1 or TSC2, on chromosomes 9p34 and 16p13, respectively. Abnormalities of these genes … Continue reading Primary steps for primary care: Tuberous sclerosis complex (TSC)

New program aims to improve access to mental health services


Disorders of the nervous system frequently include symptoms and comorbid conditions beyond those typically managed by neurologists and neurosurgeons. For example, patients with Dravet syndrome can experience hyperactivity and impulsive behavior, while patients with muscular dystrophy more frequently experience mental health disorders like depression, anxiety and other cognitive impairments. Addressing both the physical and mental … Continue reading New program aims to improve access to mental health services

Primary steps for primary care: Sleep disorders in epilepsy and cerebral palsy


Sleep disorders are common among the general pediatric population, but children with neurologic conditions are more likely to develop certain sleep disorders. Two of the most common pediatric neurologic conditions—epilepsy and cerebral palsy—and their frequently associated sleep disorders are presented here. Recognizing the elements that contribute to sleep disturbances in these unique populations can guide … Continue reading Primary steps for primary care: Sleep disorders in epilepsy and cerebral palsy

Primary Steps for Primary Care: Microcephaly


Central to a newborn examination is the tracking of growth parameters; head circumference is a key component in that evaluation. Identification of an abnormal head circumference, especially in the context of developmental delays, warrants evaluation by a neurologist and possibly a geneticist. Though it’s a frequently encountered exam finding, microcephaly is a poorly defined condition … Continue reading Primary Steps for Primary Care: Microcephaly

Neurofibromatosis type 1 – Primary Steps for Primary Care


Neurofibromatosis (NF) type 1 is a common genetic disorder, occurring in one out of 2,700 people.  It is inherited as an autosomal dominant, fully penetrant genetic disorder, though 50% of new presenters are de novo mutations. The genetic abnormality arises from the neurofibromin gene on chromosome 17 which, when intact, suppresses tumor growth.  How is … Continue reading Neurofibromatosis type 1 – Primary Steps for Primary Care

Arachnoid Cysts – Primary Steps for Primary Care


A frequent reason for urgent calls to our neurosurgery clinic is the incidental finding of an arachnoid cyst on a CT or MRI scan of the brain. Often these imaging studies are ordered for headaches, possible seizures, post-concussion symptoms or other neurologic concerns. As the ordering physician, the primary care doctor must determine what role, … Continue reading Arachnoid Cysts – Primary Steps for Primary Care

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