Should Children With Autism See a Pediatric Neurologist?
Dec 09, · If behavioral strategies have been tried, and the child is still having significant sleep issues, then a neurologist may consider doing a sleep study to study the sleep patterns of the brain. A majority of children with autism spectrum disorder have low levels of melatonin, as per research. [Melatonin is a hormone that regulates sleep.]/5. Child neurologists specialize in treating conditions of the brain and nervous system, so they are often a big help to children with autism. Your child may be recommended to see a neurologist if your doctor suspects they suffer from seizures.
Subscribe Now. Prefer email? Sign-up for our email newsletter. You've waited weeks to see your neurologist. When you arrive, she conducts a physical examination and asks about your symptoms since the last visit, all of which is vital.
But when you or a family member has a chronic or life-threatening neurologic condition—such as Parkinson's disease PDAlzheimer's disease ADmultiple sclerosis MSor a brain tumor—the concerns that keep you up what is the meaning of tpo night might not make it into those discussions.
Maybe you're concerned about your job, but you can't seem to find the right opportunity to bring it up. In the last issue of Neurology Nowwe discussed five tests or treatments that you might not need. Here, neurologists choose five questions they think patients should ask to get the best possible care. Bruce H. Cohen, M. He recommends asking your neurologist if you should get a second opinion.
Cohen says. Cohen notes. When Dr. Cohen recommends a specific treatment, he informs his patients which therapy is available at his hospital and whether treatment differs elsewhere. He often offers his first and second choice of treatment options and provides patients the opportunity to get a second opinion if additional options are offered at other facilities.
That's exactly what he did in after diagnosing a young child who had what appeared to be a slow-growing malignant brain tumor. Although he had recommended chemotherapy to the mother, he also referred her to another expert whom he respected but thought might disagree with how to change login name on windows 8. Indeed, that second neurologist recommended radiation therapy; later, a third neurologist recommended a watch-and-wait approach.
The family returned to Dr. Cohen after opting for the third option of cautious observation. And the child, now an adult, has been returning to Dr. Cohen once a year Most of the time, doctors welcome questions such as this. If for some reason your doctor is offended, you can always how to install firmware on samsung tv out our online "Find-A-Neurologist" tool what does a neurologist do for autism contact a patient advocacy what are dreams and why do we dream. Make it a point to let your neurologist know where you live and what you do for a living, and ask whether you should anticipate changes over the course of your illness that would require adjustments.
Caregivers should be involved in these discussions as well; in the case of many neurologic conditions, the patient may not have the insight to recognize when he or she is having cognitive difficulties. Miyasaki says. She recommends that patients, caregivers, and family members bring up subjects such as living space or work conditions. For example, for many people living with PD, climbing stairs may become difficult over time.
These patients may benefit from advice about how to adapt their living space, such as by adding a chair lift for the stairs or a ramp. Moving to a single-level dwelling can often help them maintain independence for longer.
In Dr. Miyasaki's experience, it may take a year or two for someone to accept the necessity of moving to a single-level dwelling. But after the first six months, she has found, most people say it was their wisest decision. It's also important for family members to discuss any of their own how to do the chi square test problems that might interfere with the caregiving role. The wife of a man with PD revealed to Dr.
Miyasaki that she was about to undergo a total hysterectomy. She hadn't considered how this would affect her husband, whom she regularly assisted up the stairs. Miyasaki was able to help arrange for temporary home care so that how to pronounce cogito ergo sum could both remain safe. Miyasaki also advises people with chronic neurologic conditions to discuss their job responsibilities with their neurologist, who may be able to help if or when modifications become necessary.
One of her patients, a research technician, noted that he had difficulty measuring liquids when his PD medications began to wear off.
She was able to support him by writing a letter requesting modification to alter his schedule accordingly. She assisted another patient, the CEO of a large investment firm, in getting long-term disability benefits. He'd developed cognitive problems as the result of his PD and couldn't properly fulfill his duties any longer.
Ronald C. Petersen, M. AAN member and director of the Mayo Clinic Alzheimer's Disease Research Center in Rochester, MN, recognizes that more testing isn't always better—especially for dementiain which biomarkers are becoming increasingly available to help identify causes.
A biomarker is a laboratory measurement that reflects the activity of a disease. Patients should also ask if a test will lead to any different recommendations or help with the prognosis, and if any risks are associated with it," Dr. Petersen says. Keep in mind that testing often is not covered by insurance. Clinical symptoms and history are often enough to diagnose AD with a reasonable degree of certainty, according to Dr.
Additional testing is typically warranted when the person has unusual symptoms—such as problems with language instead of memory—or is unusually young with no family history of AD, he says. You may be reluctant to start taking a drug because you've heard about someone doing poorly on it. Maybe you've been warned about its side effects. Sometimes, the side effects do outweigh the benefits of treatment. Asking your neurologist about possible side effects allows her to address your concerns and set the record straight about potential harms.
Jay E. Selman, M. The parents of an 8-year-old boy evaluated by Dr. Selman declined a trial of methylphenidate Ritalin for severe attention deficit-hyperactivity disorder ADHD. The reason was that the father—who'd heard methylphenidate was "just like what the street gangs were selling"—was dead set against all medications.
But after Dr. Selman informed him about what is pyrex made of side effects and explained that the medication was not addictive when used appropriately and supervised by a physician, the father agreed to a trial.
Selman recalls. When children are patients, the subject may require discussion with the patient as well as with parents. Selman explains. He typically asks children and teens to notify their parents if they don't feel well, or if something is different, so that the family may contact him. He asks older adolescents to call him directly, as well.
He advises all patients to call him immediately if they observe something of concern. Your neurologist typically discusses those side effects that he or she believes are what does a neurologist do for autism likely to occur or have the most serious consequences. Selman first addresses those that are potentially dangerous, such as a rash that may develop with the anticonvulsant lamotrigine Lamictal.
He then mentions those that may occur frequently, such as gastrointestinal upset with a nonsteroidal anti-inflammatory drug or appetite suppression and sleep problems with an ADHD drug. He likens the discussion to the other day-to-day decisions we all make about relative risks and benefits.
We do the same thing when we weight the benefits of the treatment versus the potential adverse effects. Giving the patient and the family as active a role as possible in decision-making is important to Dr. Selman, who lets patients know he will continue to work with them, even if they decide not to follow his recommendations. Lily Jung Henson, M. But patients may care more about how they feel between the disease episodes or as a result of the side effects of the medicine," she notes.
But, the patient might be miserable because she is unable to participate in activities she used to love, like going to her child's soccer game," Dr.
Jung Henson says. In addition, Dr. Jung Henson says, she would discuss adjusting the woman's schedule to leave more energy for soccer games, consider prescribing anti-fatigue medications to give her more energy while there, and recommend that she wear a cooling vest and drink cool liquids in very warm weather. The goal of a given treatment may not directly address quality of life, such as physical activity, social activity, personal fulfillment, mobility, and independence.
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May 04, · The role of the child neurologist is to analyze each case, and to use all means available to try to find the cause of the problem. In the vast majority of cases, this is genetic. They will then need to do everything possible to ensure that the child with autism can achieve the maximum development possible within his or her limitations. Children with autism spectrum disorder (ASD or autism) may see a child neurologist, in order to deal with sensory issues or behavioral issues associated with autism. What Do Neurologists Do? Child neurologists diagnose and treat a variety of conditions. Neurologists deal with children who have seizures, head injuries, or muscle weakness. Jun 18, · Child neurologists treat children from birth into young adulthood and often diagnose, treat, and manage neurological conditions, including ASD. A Child and Adolescent Psychiatrist is a physician who specializes in the diagnosis and the treatment of disorders of thinking, feeling, and/or behavior, which affect children, adolescents, and their families.
To help educate patients and families, Dr. Deepa U. Menon answered questions from the Interactive Autism Network IAN about the role of neurologists in treating children and youth with autism.
Her research interests include metabolic and mitochondrial disorders associated with autism, regression in autism, and early identification and treatment of autism and communication disorders. IAN: When should the parents of a child with autism spectrum disorder consider taking him or her to a neurologist?
Menon: Child neurologists specialize in identifying and treating disorders of the nervous system and brain. Parents may consider consulting a neurologist if they notice:.
Other reasons that someone might see a neurologist are a history of prematurity, a concern that the child has a large head or a small head, or anything that makes you think there's a medical cause for the child's autism, such as a mitochondrial disorder. Menon: Seizures are slightly more common in children with autism than in the typically-developing population. In the general population, the incidence of seizures is 1 to 5 percent. In autism the chances of having seizures are 10 to 20 percent.
IAN: How can families recognize the different types of seizures that can occur in autism? Menon: A seizure is a sudden surge of electrical activity in the brain. The two types of seizures are focal seizures — seizures occurring in part of the brain — and generalized seizures, which occur over the entire brain. Focal seizures can occur with or without a loss of consciousness.
A petit mal or absence seizure is a type of generalized seizure. It looks like a staring spell and lasts less than 10 to 15 seconds. A child might be playing, then he will stop and stare or appear blank, and then go back to what he was doing without any obvious delay or change.
Another kind of generalized seizure is the grand mal or tonic-clonic seizure. The arms, legs, and body may stiffen and shake uncontrollably during this kind of seizure. After this seizure, most children will have a period of being tired or confused, and may go into a deep sleep.
Children with a genetic syndrome, such as tuberous sclerosis, and autism might have more complicated or longer seizures. Landau-Kleffner Syndrome is a rare disorder of night-time seizures over the temporal regions of the brain that are involved in the use of language.
These children lose language. The symptoms are very similar to autism but occur in a slightly older age. They will develop typically until five to seven years of age, when they start losing language. Landau-Kleffner can be treated with medication such as corticosteroids. IAN: Can it be difficult for parents or teachers to distinguish the behavioral symptoms of autism — such as not responding to one's name and staring into space — from signs of an absence seizure?
Menon: It is often hard, even for a neurologist, to detect brief seizures. Often when a child is being sent for an EEG [electroencephalogram, a test for seizures], it's because they have had a staring spell.
Often a single EEG may not pick up on a seizure disorder. Menon: First you start with a patient history and a good physical exam. You're also looking for marks on the skin that might be a sign of syndromes or genetic causes of autism, like tuberous sclerosis. In terms of testing, the main one would be an EEG. The test can detect seizures. We usually try to have an extended EEG because we would be more likely to detect a seizure. In children with a history of regression, we try to get an overnight EEG that will capture a longer period of time six to eight hours.
Seizures are frequently associated with the sleep cycle. You tend to have a higher frequency of seizure activity when the child is falling asleep, asleep, or coming out of sleep. In the past, you always had to come into the hospital to get this test done, but for a certain group of children who cannot stay in the hospital, there is an ambulatory EEG.
These are portable machines that can be used in the home. The video EEG records both the brain waves via the electrodes, and a video film of the child's activity while the EEG is being recorded. An additional test that might be done is a brain MRI. If a child has a focal seizure, which means he always has a seizure involving just one arm or leg, for example, you might do an MRI to see if there is any abnormality in the region of the brain that controls that limb.
In rare cases of seizures that occur in the setting of a fever or infection, a lumbar puncture may be done to see if there is an abnormality of electrolytes, or if there is an infection or inflammation, that is causing the seizure. Menon: Sleep problems are very common in typically-developing preschool and school-aged kids, too, and it can be a behavioral issue. However, in children with autism the incidence of sleep disorders is higher, both in falling asleep and in maintaining sleep.
If behavioral strategies have been tried, and the child is still having significant sleep issues, then a neurologist may consider doing a sleep study to study the sleep patterns of the brain. A majority of children with autism spectrum disorder have low levels of melatonin, as per research. Or if they do go to sleep, they have difficulty maintaining sleep and wake up frequently or very early in the morning.
That does affect the child's and family's quality of life. IAN: What's a seizure threshold, and do people with autism have lower thresholds? Menon: A seizure threshold is the level at which the brain will have a seizure. There are certain triggers for a seizure, even in people who don't have autism, such as an infection or a high fever, or if someone is on medication for seizures and misses a dose of the medication, or if there's a sleep abnormality and the person has had decreased sleep.
All of those things may make it more likely the person will have a seizure. A child who doesn't have autism may only have a seizure when he has three or four of these factors, but a child with autism might have a seizure when he only has one of these factors.
That is a lower threshold. Some children with autism are on medication for management of behavior, and some of those medications, as a side effect, can cause seizures. Menon: There are two peaks that occur, one during the toddler years from ages 1 to 4, and again, during the teenage years.
Menon: Some children have absence seizures in early childhood, and have been on antiseizure medication for two to three years and completely seizure-free. In those cases, we might try to wean them from seizure medication. But it's also important to be careful around the teenage years. A teenager might not sleep at the right times, be exhausted, and not eat well. If a teenager had seizures when he was younger, it's something for parents to keep in the back of their minds, to monitor him to make sure there's no reoccurrence of seizures in the teen years.
Do you treat that? Menon: The jury is out on that question. You wonder, "Should you treat the child or not? Some neurologists believe that you should treat any EEG abnormality, but others say you shouldn't because seizure medications have side effects. If you start seizure medication treatment, you are committing the child to a minimum of two to three years of treatment.
You have to consider what are you treating, what is your end point of treatment, and how will it affect the development of the child. Skip to main content. Utility Menu Events Blog. Date Published:. December 9, Parents may consider consulting a neurologist if they notice: Their child is not developing at the same rate or pace as other children the same age, If there are delays in motor skills, speech and language, and social and play skills, If they notice red flags for autism including delays in social communication and play, and an increase in repetitive behaviors and behavioral disruption, If there is a loss of previously-acquired developmental milestones, like speech or eye contact or play.
Parents may say, "My child was doing very well, and all of a sudden he's not progressing, or he's losing skills. If there is a history of seizure-like jerking movements or staring spells indicating a possible seizure, If there are concerns of hyperactivity, sleep issues, feeding problems, If there's a concern about hypotonia [low muscle tone] or motor abnormalities — if the child is a very floppy baby or one side of his body is stronger than the other.
IAN: Are seizures more common in people with autism? IAN: What are the types of tests a neurologist might perform? IAN: Are sleep problems a sign of a neurological disorder? IAN: When are children most likely to develop seizures? IAN: Do children who take seizure medications have to take them for many years?
Please rate the helpfulness of this article:. Additional Resources:. More about Dr. Diagnosis and autism. Seizures and autism.