Pediatric Neurosurgery Frequently Asked Questions

Pediatric neurosurgeons deal with the treatment and management of nervous system disorders, head and spinal cord deformities in children. They can also diagnose and treat the following conditions.

• Gait disturbances or spasticity
• Birth injuries involving weakness of the arms and legs.
• Brain, spinal cord, or nerve problems and injuries

Pediatric neurosurgeons are medical doctors who have performed:

• At least 4 years of medical school studies
• One year surgical internship
• Five or more years of training as a resident in neurological surgery
• Additional training in pediatric neurosurgery
• Certification by the Neurosurgery and Pediatric Neurosurgery Council of each country
• Pediatric neurosurgeons treat children from birth through the teenage years. They chose pediatrics as the focus of their medical practice, and learned the unique nature of medical and surgical care for children through advanced training and practice experience.

Symptoms of nervous system disorders in children can vary. Different disorders can cause different symptoms, some of which may include:

• Muscle stiffness, tremors, or seizures
• Lack of coordination
• Delayed development
• Increase or lack of growth in the size of the head
• Changes in level of consciousness or mood
• Changes in activity, reflexes, or movements
• Muscle loss and slurred speech
• Persistent or severe headaches, loss of sensation

The nervous system is a highly complex and specialized network in the body, mainly in the developmental stages of children. Problems that affect the nervous system depend on which part of the nervous system is involved and what is causing the problem. Some conditions, injuries, or illnesses that can cause nervous system problems include:

• Blood supply or vascular disorders
• Trauma
• Head and spinal cord injuries
• Degeneration
• Mental health problems, such as depression, psychosis, and anxiety disorders.
• Immune system disorders
• Tumors
• Structural defects
• Infections
• Interruption of blood flow
• Congenital genetic or metabolic problems
• Toxic exposures or direct effects of drug exposure

The diagnosis of epilepsy is usually made if a child has seizures more than once without an identifiable reason such as an injury or fever. Children experiencing unprovoked seizures without any known diagnosis of epilepsy should seek immediate medical attention followed by a visit to their primary care pediatrician soon after.

The diagnostic process in each child will vary, but the main steps generally include:

• Diagnosis begins by asking questions about the medical history, which may also include questions about the mother’s delivery and pregnancy, and symptoms.
• The parents of the child must give a detailed report of the seizure.
• Physical exams to assess cardiac, neurological, and mental status
• Blood tests to check for any major disease or other possible causes
• Computerized axial tomography or computed tomography to identify if an injury or acute neurological disease has caused the seizure.
• Electroencephalogram to assess the risk of seizure recurrence
• Magnetic resonance imaging

Epilepsy is a complex condition and its treatment usually begins with medication. Many seizure prevention medications are available to treat the symptoms of epilepsy by reducing the frequency of seizures. However, these medications do not change the brain’s underlying susceptibility to seizures.

Such drugs work effectively only after they reach a certain level in the body and that level must be maintained. If medications don’t work, other options to consider include:

• Brain surgery
• Medical devices to prevent and control seizures
• Dietary therapies