Subspecialty Programs

Child Neurology Program

Mission Statement

The Division of Child Neurology's mission is to provide the best possible care for patients with childhood neurologic disorders by establishing excellence in education and research through diverse programs in clinical and basic neurosciences.

Beliefs

1. Medical education requires intellectual curiosity, sharing knowledge, and continued
learning.
2. All individuals deserve quality care independent of their resources.
3. Academic medical institutions should facilitate academic and service opportunity for
medical staff, residents and trainees.
4. Medical education requires participation and responsibility.
5. Patients with subspecialty disorders coming to a tertiary institution should have early
involvement of the appropriate subspecialty.

Some facts about Child (Pediatric) Neurology

Child neurologists diagnose, treat, and manage diseases, disorders, or dysfunction  of the central and peripheral nervous system (brain, spinal cord, nerves, and muscles).

Such diseases include epilepsy, cerebral palsy, mental retardation, muscular dystrophy, headaches, nervous system complications of systemic diseases or infections like meningitis and encephalitis, metabolic and genetic diseases of the nervous system, learning and behavioral disorders in infancy, childhood, and adolescence.

Child neurologists are medical specialists, and therefore treat with medications or non-surgical therapeutic procedures.  However, they often work individually with neurosurgeons to manage joint patients, or in multidisciplinary teams that involve neurosurgeons, such as in epilepsy or spasticity management.

How to tell if there is a problem?

Symptoms are either acute, subacute, or chronic, and may indicate loss of previous functioning, or delay in obtaining normal functioning, like walking, talking, and social interaction.  Loss of motor function can manifest as weakness or paralysis, loss of balance or fine motor coordination, or the development of abnormal, involuntary movements.

Loss of mental/behavioral function can appear as decline in school work, loss of previously acquired speech and language, memory or social behavior.  Loss of vision or hearing may indicate a neurologic problem.  Loss of consciousness might indicate a seizure disorder.  Delays in development may occur in motor, mental, behavioral or social realms.

Parents with concerns about their child's neurological development are advised to first discuss their concerns with their pediatrician, who can determine if consultation with a neurologist is necessary.

Precautions

Measures to prevent neurologic disease by preventing accidents--"safe" toddler-proof kitchens and bathrooms to prevent accidental poisoning that can affect the nervous system; helmets for bicyclists, motorcyclists, skiers and snow boarders; tightening automobile seat belts to prevent serious head or spinal cord injury; no driving when drinking; and life jackets when canoeing or boating to prevent brain damage from drowning.

Many serious infections that might affect the brain and nervous system can be prevented by adhering to recommended vaccination/immunization schedules.  AIDS-Dementia Complex and the infectious complications of HIV that affect brain can be prevented by safe sex.  Meningitis vaccines in vulnerable places and times--epidemics in school or college-age children are recommended--can prevent meningococcal meningitis.  Lyme Disease and mosquito-borne summer encephalitides can be prevented by appropriate clothing in high risk endemic areas, mosquito repellent, and avoiding evening exposure.

Adolescent or young adult epileptic patients taking antiepileptic drugs who contemplate conceiving children can take folic acid supplements to prevent brain and spinal cord malformations in future infants.  Many instances of "cerebral palsy" may be prevented by prompt and continuous prenatal care. What can we do as a community?

Know your family's medical history well.  This is particularly important in genetic diseases, which is an area that has rapidly developed because of DNA biotechnology and the Human Genome Project.  Be aware of potential environmental toxins, such as houses with lead paint, pesticides, contaminated water, wildlife, or food, or industrial chemical dumping sites.  Advocate for universal access to prenatal care and child care--a primary care physician for every child. If your child has a neurologic disorder or neurodevelopmental disability, become active in the voluntary organizations for those disorders, such as the Epilepsy Foundation, the Learning  Disabilities Association, Children and Adults with Attention Deficit Disorder (CHADD), the Tourette Syndrome Association, the Association for Retarded Citizens (ARC) or the National Organization of Rare Disorders (NORD). Support community Early Intervention Programs and public school pre-school handicapped programs.

Faculty

There are three full-time academic faculty substantially committed to the pediatric neurology:

Program Director:

David E. Mandelbaum, MD, PhD
Professor of Clinical Neurosciences and Pediatrics

Other faculty:

William D. Brown, MD
Assistant Professor of Clinical Neurosciences and Pediatrics
Karameh Hawash, MD
Assistant Professor of Clinical Neurosciences and Pediatrics

Associated faculty members include:

Muscular Dystrophy:
Karen Kerman, MD
Pediatric Neurosurgery:
John Duncan III, MD, PhD
Child Psychiatry:
Henrietta Leonard, MD
Neuropthalmology:
Marjorie Murphy, MD
David Robbins-Tien, MD
Neurodevelopmental Disabilities and Neurorehabilitation:
Michael Msall, MD