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Conditions & Treatments

The neurophysiology team works with your child’s doctors and surgeons by performing highly specialized tests to make an accurate diagnosis of your child’s specific condition, whether it is headaches or a rare genetic disorder.

Our technicians and nurses partner with your child’s care team to determine the best course of action and to closely monitor your child during surgery and treatment.

Epilepsy

Epilepsy is a condition where abnormal electrical activity in the brain causes seizures for no other obvious medical reason. About 0.6 percent of children up to age 17 have active epilepsy. The condition affects each child differently:

  • For some children, the condition is easily controlled with medicine.
  • For other children, epilepsy is a lifelong condition that affects many parts of life.
  • Some children outgrow the condition with time.

Epilepsy can be treated with medicines and surgery. Children with more severe epilepsy may benefit from a vagal nerve stimulator. This pacemaker like device controls signals along the vagus nerve in the neck to reduce and control seizures.

Syncope

Syncope is an involuntary body response that causes fainting. During syncope, the heart rate slows and the blood vessels dilate, which means less blood gets to the brain. A child who is about to faint may feel:

  • Dizzy or lightheaded
  • Nauseous
  • Vision whites out or blacks out

Syncope can be caused by a variety of situations, such as:

  • Vasovagal syncope
  • Orthostatic hypotension (standing up too fast)
  • Heart defects
  • Irregular heartbeat
  • Inflammation of heart muscle (myocarditis)

Treatments include avoiding situations that may cause a vasovagal response, such as scary or stressful events. Other treatments include treating any underlying conditions that may cause syncope, such as repairing a heart defect.

Undiagnosed Fainting Spells

Undiagnosed fainting spells can be scary and unsettling. The cause of frequent or periodic fainting can be simple—such as low blood sugar from skipping a meal—or more complex, such as a heart or neurologic condition. The exact cause can be difficult to pinpoint, as some common tests do not always detect certain conditions. At Arkansas Children’s we perform a variety of diagnostic checks to help uncover what is making your child faint. Depending on the cause, treatments may include medicines, implanted defibrillators, surgery, nutrition counseling or biofeedback.

Scoliosis

Scoliosis is when abnormalities in the bones of the spine make it bend sideways. This can cause:

  • Pain
  • Trouble breathing
  • Problems with normal development and growth

Surgery is used to correct the curve in the spine, relieve symptoms and prevent further damage. Specially trained surgeons will use rods and other devices to strengthen and straighten the spine so that a child can continue to grow more normally.

At Arkansas Children’s we provide the most advanced surgical treatments, including surgical monitoring technology to protect the spinal cord and ensure proper placement of corrective hardware.

Chiari 1 Malformation

A Chiari 1 malformation is when the cerebellum (a part of the brain) comes through an opening at the base of the skull. Normally this space only contains the spinal cord. The condition is most often diagnosed in adolescence and adulthood and often is found by coincidence. Many children with a Chiari 1 malformation have no symptoms. As many as 50 percent of patients also have other conditions, including:

  • Cervical spina bifida
  • Scoliosis

Symptoms Chiari I malformations include:

  • Severe head and neck pain
  • Dizziness
  • Balance problems
  • Blurred or double vision
  • Sensitivity to bright lights
  • Severe muscle weakness

If a child has no symptoms, no treatment is needed. When symptoms are severe, surgery can correct the abnormal position of the cerebellum.

Tethered Cord

A tethered spinal cord occurs when the spinal cord is stretched like a rubber band. Abnormal tissue connections limit the movement of the spinal cord. Tethered cord can happen with other related conditions, including:

  • Spina bifida
  • Abnormal fat in the spinal cord
  • A tighter than normal connection between the spinal cord and the tailbone

A tethered spinal cord can cause:

  • Low back pain
  • Leg pain and numbness
  • Difficulty walking
  • Foot abnormalities
  • Scoliosis
  • Problems with bladder and bowel control

Treatments include bracing to strengthen the back and muscles around the spinal cord. Sometimes surgery is needed to relieve symptoms and surgery

Posterior Fossa Tumor

A posterior fossa tumor is a brain tumor found at the bottom of the skull. These tumors are usually primary brain cancers. If they grow large enough they may block the flow of spinal fluid, cause increased pressure on the brain and spinal cord and damage the cranial nerves. Symptoms caused by these tumors include:

  • Headache
  • Drowsiness
  • Imbalance
  • Nausea and vomiting
  • Eye and vision problems
  • Facial muscle weakness
  • Hearing loss

Surgery is used to remove posterior fossa tumors, even if they are not cancerous, because the presence of the tumor can damage other nerves and other structures in the brain. Radiation treatment may also be used.

Neurodegenerative Diseases

Neurodegenerative diseases are a group of rare conditions that involve the loss of neurological functions, such as walking or other movements, because of structural abnormalities in the central nervous system. These disorders can be genetic or nongenetic. The causes of many of these conditions are unknown, but may include factors such as:

  • Metabolic
  • Viral
  • Immunopathic
  • Environmental
  • Epileptogenic

More frequently occurring neurodegenerative diseases include:

  • Tuberous sclerosis with degeneration
  • West disease (idiopathic degenerative encephalopathy associated with infantile spasms)
  • Werdnig-Hoffmann disease
  • Hereditary spastic paraplegia
  • Subacute sclerosing panencephalitis
  • Neuronal ceroid lipofuscinosis

Treatments include addressing symptoms. Other treatments depend on the specifics of the condition. For example, if the condition is metabolic in nature, nutritional treatments may help.

Neurogenetic Diseases

Neurogenetic disorders are conditions caused by changes in genes and chromosomes. These changes can affect the brain, spinal cord, nerves and muscles and can cause health problems at birth or later in childhood. There are different types of neurogenetic conditions but only some are inherited. Symptoms vary and can get worse or improve with time. Some neurogenetic disorders include:

  • Autism
  • Brain malformation
  • Developmental delay
  • Neurofibramotosis
  • Epilepsy
  • Metabolic disorders
  • Neuromuscular disorders
  • Pediatric stroke
  • Neurodegenerative disorders

Treatments depend on the specific condition and most often include procedures or medicines to reduce and control symptoms.

Tuberous Sclerosis

Tuberous sclerosis is a neurocutaneous disorder. This condition causes benign growths called tubers to form in the brain and on other organs, such as the eyes, kidneys, heart, lungs and skin. Children with tuberous sclerosis also may experience:

  • Noncancerous tumors
  • Uncontrolled epilepsy
  • Developmental delay
  • Abnormal heartbeat
  • Abnormal skin on the face or back

Treatments include medicines to control seizures, surgery to reduce symptoms, chemotherapy to treat brain growths.

Spinal Muscular Atrophy

Spinal muscular atrophy is a genetic disorder caused by the loss of specialized nerve cells that control muscle movement. The specialized nerve cells are motor neurons and are found in the spinal cord and the brain. When the muscles do not receive signals from the nerves, they shrink and become very weak. Symptoms:

  • Can begin at different ages
  • Can be mild to severe

Treatments include medicines used to delay the disease progression and physical therapy to help strengthen muscles.

Neurofibromatosis 1

Neurofibromatosis 1 is a condition where tumors grow on nerves throughout the body. This can cause multisystem disorders of the central nervous system, including in the brain, spinal cord and the cranial nerves. Symptoms may include:

  • Light brown skin spots ("café au lait" spots)
  • Growths under the skin
  • Learning challenges
  • Soft bones
  • A curved spine

Treatment is designed to reduce symptoms. If tumors on or under the skin cause pain, they can be surgically removed. Surgery may also be used to remove tumors that are pressing on nerves or other organs.

Electroencephalogram (EEG)

An electroencephalogram (EEG) is a test that records and evaluates the electrical activity in the brain. There are different ways that EEG is used to diagnose and monitor and variety of

  • Routine and portable EEG. This form of EEG is often used to evaluate people with epilepsy. It records brain activity for 20 to 30 minutes.
  • Outpatient prolonged video EEG. This type of EEG records video and the brain’s electrical activity for 1 to 2 hours or up to three days at home.
  • Intraoperative monitoring for neurosurgery and orthopedic surgery. This is an inpatient for of EEG that monitors a patient’s brain activity during a surgical procedure.
  • Extensive long-term video EEG. This inpatient type of EEG is used for medical and surgical treatment of epilepsy. It can also be monitor patients in critical care, especially in the neonatal, pediatric and cardiovascular intensive care units. Extensive long-term video EEG is often used to monitor patients as they are weaned off certain medicines or to create certain reactions to test brain activity.

Electromyography (EMG)

An EMG is a test used to determine the electrical activity of the muscle at rest and when the muscle is used.  An EMG is used to help find neuromuscular abnormalities. Small needles called electrodes are inserted through the skin and into the muscle to perform the exam.

Nerve Conduction Study (NCS)

The nerve conduction measures the speed of electrical impulse through a nerve to determine if there is nerve damage or destruction. Electrodes are used to stimulate the nerve with a small electrical stimulus. This test is often used in conjunction with an EMG to look at how the muscles are working. 

Evoked Potentials

Evoked potentials is a study of the electrical activity in the brain as it responds to a stimulus. This test is used to measure how the brain responds to sight, sound or touch, as the signals travel along the nerves to the brain. This test is often used as part of making a diagnosis of multiple sclerosis.