Pediatric Neurology

Autism spectrum disorder (ASD) is a set of complex neurodevelopment disorders marked by repetitive patterns of behavior and difficulties with social communication. The symptoms are present from early childhood and affect activities of daily life.

Neurologists are part of the multidisciplinary team — including a psychologist, psychiatrist, speech therapist, developmental and behavioral specialist, and other professionals — that diagnoses and treats children who have ASD.

Individuals who have autism spectrum disorder have an above-average risk of having epilepsy, another medical condition that neurologists treat.

Our pediatric neurology specialists collaborate with experts in the pediatric hematology/oncology program and in pediatric neurosurgery to treat children and young adults with brain tumors.

Close to 2,000 children in the United States are diagnosed with a brain tumor each year —ranging from aggressive malignant tumors to slow-growing benign tumors.

The multidisciplinary team at Hasbro Children’s Hospital shares the care of each patient and family with the goal of the best long-term outcome for each child.
 

Cerebral palsy (CP) is the most common movement disorder in children and most often is congenital (present from birth). In CP, abnormal brain development affects a person’s ability to control his or her muscles.

CP is classified according to which areas of the brain are affected: spastic (causing stiff muscles); dyskinetic (uncontrollable movements); and ataxic (poor balance and coordination). Some patients have symptoms of more than one type.

About 40 percent of children who have CP also have epilepsy, and 10 percent have autism spectrum disorder.

About 200,000 cases are diagnosed annually in the United States.
 

A concussion is an injury to the head (mild traumatic brain injury) that may cause instant loss of awareness or alertness for a few minutes up to a few hours after the event. Some are mild and brief, and the individual or an untrained observer may not recognize that a concussion has occurred.

Falls, motor vehicle accidents, assaults, and sports injuries may cause concussions that require emergency treatment. Children, young adults, and older adults are at especially high risk for concussions and may take longer to recover.

Symptoms include headache, memory problems, trouble walking, dizziness, and vision problems.
 

Epilepsy is a complex condition that makes a child susceptible to seizures, which are caused by abnormal electrical activity in the brain. Epilepsy can have a significant impact on quality of life, with seizures and co-occurring conditions such as depression and learning disabilities impacting school and work performance.

Our multidisciplinary team of experts in the pediatric epilepsy program at Hasbro Children's Hospital collaborates to identify the best treatment options to control the seizures and give the child an optimal quality of life.

Headaches may be a symptom of a serious disorder, but chronic headaches of any kind can lead to learning difficulties, behavioral problems and/or depression.

Nearly 40 million Americans suffer from migraines. Among them are approximately 10 percent of children ages 5 to 15 and as many as 28 percent of teens.

Tension commonly is at the root of headaches in children. However, a child should be examined by a health care provider if their headache follows a blow to the head; comes on with coughing, sneezing, or straining for a bowel movement; accompanies pain in the eye or ear, sensitivity to light and sound, confusion, nausea or vomiting; or occurs along with fever and a stiff neck.

The nervous system comprises the brain, spinal cord, the sensory organs, the sensory and motor nerves. It controls the body and communications within it.

Infections and inflammation can impair the nervous system. Inflammation causes swelling of the tissue or blood vessels in the brain.

Central nervous system vasculitis (inflammation of the blood vessels) is the most common inflammatory brain disease diagnosed in children.

Meningitis and encephalitis — inflammation of the membranes surrounding the brain and spinal cord, or the brain itself— may be caused by bacterial or viral infection and may lead to disability or death.

Reye syndrome triggers brain swelling and liver damage. It’s most common in children and teens who are recovering from a viral infection. Research has shown a connection between the syndrome and taking aspirin during or after a viral illness. When diagnosed and treated quickly, many children make a full recovery.

Transverse myelitis is another kind of inflammation, affecting both sides of the spinal cord. It can cause pain, weakness, paralysis, sensory problems, or bladder and bowel dysfunction.

Neurometabolic disorders cause problems with both metabolism (how cells process nutrients to get energy) and the function of the brain.

These rare disorders are varied in their origins and the organs and systems they affect, potentially causing seizures, vision or hearing loss, breathing difficulties, decline of developmental skills, gastrointestinal, and other neurological problems.

Neurocutaneous disorders affect the brain, spinal cord, bones, organs, and skin. Tuberous sclerosis, neurofibromatosis, and Sturge-Weber disease are the three most common. They are caused by genetic changes (mutations) and are called congenital because they are present from birth.

Neurofibromatosis spurs growth of tumors in the nervous system. Tumors originate in the cells that make up the nerves and the membrane that protects them (called the myelin sheath).

There are three types of neurofibromatosis. The most common, NF1, causes tumors to grow on nerves and, less often, in the brain and spinal cord. Abnormalities such as skin changes and bone deformities may occur. NF2, often arising in the teen years, inflicts hearing loss, tinnitus (ringing in the ears), and poor balance. Schwannomatosis, the rarest type, is most often diagnosed in adulthood.

A birthmark on the face called a port-wine stain is a sign of Sturge-Weber disease. With this disorder, there may be brain abnormalities, seizures, muscle weakness, vision problems, and intellectual disability.

Tuberous sclerosis causes growths in the brain and retina of the eye. It also affects many other organs, and may cause developmental delays, seizures, and learning disabilities.

Our experts work within the Children's Neurodevelopment Center at Hasbro Children's Hospital to provide evaluation and treatment of children with neurological, genetic, developmental, metabolic, and behavioral disorders. These include attention deficit/hyperactivity disorder, autism, cerebral palsy, epilepsy, and more.

There are many neuromuscular disorders. Two that are familiar to many people are muscular dystrophy and multiple sclerosis.

Muscular dystrophy is a group of genetic diseases that cause progressive weakness of the body's muscles. Depending on the type, congenital muscular dystrophy may cause joint stiffness or looseness, spinal curvature, and respiratory insufficiency, and may be accompanied by intellectual disabilities, learning disabilities, eye defects, or seizures. Duchenne muscular dystrophy is the most common form of childhood muscular dystrophy and mainly afflicts boys, with symptoms arising between ages 3 and 6.

Multiple sclerosis (MS) begins when a person’s immune system starts attacking the myelin coating around the nerve fibers in the central nervous system (the brain and the spinal cord) and damaging the nerve fibers themselves. This interrupts the communication of nerve signals among the brain, the spinal cord, and the rest of the body. Symptoms include fatigue, blurred or double vision, numbness and tingling, weakness, poor coordination and balance, pain, depression, and problems with memory and concentration. While multiple sclerosis is the leading cause of disability in adults ages 20 to 40, it now is being diagnosed in younger patients.

Just like adults, children can have strokes. These can be ischemic (caused by a blockage of blood flow to the brain areas) or hemorrhagic (caused by bleeding in the brain). 

Once your child has come through the immediate health crisis, he or she may have difficulty walking, seeing, or speaking. Depending on the location of the stroke in the brain, one side of the body may be affected more than the other. A seizure disorder or changes in thinking or emotions all can be aftereffects of stroke.

A multidisciplinary team will care for your child from the emergency room through rehabilitation.

A child who has a neurological condition called a tic disorder makes involuntary movements and sounds. Blinking, shrugging, grimacing, cursing, or hooting are some of the acts a child feels compelled to do. Tourette syndrome is classified as a chronic tic disorder.

Anxiety, excitement, or stress can trigger tics. Some tic disorders are associated with obsessive-compulsive disorders, ADHD, or mood disorders (anxiety and/or depression).

Three to four times as many boys as girls have tic disorders, which are diagnosed early in life and may diminish as the child ages into young adulthood. Medical treatment and behavioral therapy are available.