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Hydrocephalus is a serious neurological condition caused by an abnormal buildup of cerebrospinal fluid (CSF) in the brain. For children, this can lead to increased brain pressure, which, if untreated, can affect cognitive, neurological and physical development. Addressing pediatric hydrocephalus early is essential to ensuring your child’s good health and well-being. In this guide, we’ll explore the types of pediatric hydrocephalus, available treatment options, and how the New Jersey Pediatric Neuroscience Institute (NJPNI) provides expert care for patients with hydrocephalus.

What Is Pediatric Hydrocephalus?

Pediatric hydrocephalus occurs when the brain's normal circulation and drainage of CSF is disrupted. The excess fluid leads to increased pressure that can damage brain tissue and impair function. Normally, a child’s brain makes 5-15 cc ( 1- 3 teaspoons) of fluid every hour. This fluid circulates around the brain and is absorbed at the same rate.

Types of Pediatric Hydrocephalus

Communicating Hydrocephalus: Communicating hydrocephalus occurs when the brain is making fluid, and it circulates, but is not being absorbed well. Sometimes this occurs in the setting of macrocephaly ( a large head size). Babies with macrocephaly are often referred to a pediatric neurosurgeon. These infants will usually be sent for an ultrasound of the brain. The ultrasound may show that the CSF spaces are enlarged. Most infants outgrow this condition, that is called Benign Enlargement of the Subarachnoid Spaces (BESS) or Benign External Hydrocephalus (BEH).Infants with BESS or BEH are usually followed until age three years. Occasionally though, the communicating hydrocephalus does not resolve. In rare cases, these children require a ventriculoperitoneal shunt if they developed hydrocephalus with progressively enlarging ventricles. Obstructive Hydrocephalus: This occurs when a blockage prevents the flow or circulation of CSF through the brain’s ventricles. Normal Pressure Hydrocephalus (NPH): More common in older individuals but sometimes seen in children, this condition results from impaired CSF absorption, leading to symptoms despite “normal” pressure levels. Accurate diagnosis is critical in determining the most effective treatment strategy for your child.

Advanced Treatment Options for Pediatric Hydrocephalus

Shunt System

The ventriculoperitoneal shunt system is one of the most widely used treatments for hydrocephalus. It involves surgically placing a small tube in the brain to redirect excess CSF to another part of the body, such as the abdominal cavity, where it can be absorbed. Key Features: Includes a valve to regulate CSF flow and pressure. Can be adjusted for long-term use, making it a reliable option for children. Effectiveness: Shunts are a proven solution for managing hydrocephalus over the long term.

Endoscopic Third Ventriculostomy (ETV)

ETV is a minimally invasive procedure in which a small camera (endoscope) is used to create a bypass in the brain’s ventricles, allowing CSF to flow freely. Benefits: Often used for obstructive hydrocephalus. Avoids the need for lifelong shunt management in some cases. Considerations: Not always a permanent solution; success depends on the individual case.

Endoscopic Third Ventriculostomy with Choroid Plexus Cauterization (ETV/CPC)

This advanced technique combines the benefits of ETV with the reduction of CSF production by cauterizing the choroid plexus. Advantages: Particularly effective for infants and young children. Reduces the likelihood of future complications by addressing both fluid flow and production. Considerations: Requires thorough evaluation by a pediatric neurosurgeon to ensure suitability.

Managing Normal Pressure Hydrocephalus (NPH)

While NPH typically affects older individuals, the treatment parallels pediatric hydrocephalus in many ways, especially through the use of shunts. Symptoms of NPH: Gait disturbances Cognitive decline Urinary incontinence Treatment: A ventriculoperitoneal (VP) shunt is commonly used to manage NPH, alleviating symptoms and improving quality of life.

The health and well-being of our children are paramount to every parent. As they grow, they will undoubtedly face various health challenges – from the common cold to more serious conditions. One area that sometimes gets overlooked, due to its complexity, is the neurological health of our children. While most pediatric concerns might be adequately addressed by a general pediatrician, there are times when the specialized expertise of a child neurologist becomes essential. But when exactly should you consider consulting one?

Understanding the Role of a Child Neurologist

Child neurologists specialize in diagnosing, treating, and managing disorders of the nervous system (brain, spinal cord, muscles, and nerves) in children. Their expertise covers a wide range of conditions, from migraines to epilepsy, developmental disorders, and more. They combine the special skills of pediatrics and neurology to provide comprehensive care tailored to the needs of children.

Key Indicators to Consult a Child Neurologist

• Developmental Delays: If your child isn't meeting specific developmental milestones – such as walking, talking, or other age-appropriate skills – it may be an indicator of a neurological issue. While many children catch up with their peers eventually, a noticeable lag can warrant further investigation.
• Seizures or Epileptic Signs: Any episodes of uncontrolled movements, staring spells, or loss of consciousness might be a sign of a seizure. Epilepsy is a condition where a person has recurrent seizures due to a chronic underlying process.
• Frequent or Severe Headaches: While occasional headaches can be common, frequent, severe, or migrainous episodes should be evaluated by a neurologist to rule out underlying conditions and provide effective treatment.
• Muscle Weakness or Coordination Issues: If your child appears clumsy, has difficulty with fine motor skills, or experiences muscle weakness, it might be time to seek a specialized opinion.
• Changes in Behavior or Mood: Sudden behavioral changes, mood swings, or academic struggles can sometimes be linked to neurological conditions. This might include attention problems, anxiety, or even bouts of aggression.
• Neurogenetic Disorders: Conditions like neurofibromatosis, tuberous sclerosis, or Rett syndrome are complex neurogenetic disorders that require specialized care and monitoring.
• Sleep Disturbances: While many children experience occasional sleep disruptions, chronic problems like insomnia, night terrors, or sleepwalking can sometimes have neurological roots.

When in Doubt, Seek Expertise

If your child is displaying symptoms or behaviors that concern you, the first step is always to consult your primary pediatrician. They can provide initial assessments and referrals if necessary. However, if your child's symptoms persist, worsen, or if you believe they might have a neurological component, don't hesitate to consult a child neurologist directly.

Conclusion

A child neurologist's expertise ensures that complex neurological conditions are accurately diagnosed, effectively treated, and well-managed throughout your child's developmental years. Remember, early intervention often leads to better outcomes. Prioritizing your child's neurological health today can pave the way for a healthier and brighter tomorrow.

Pediatric epilepsy is a neurological disorder that affects children, posing significant challenges to their development and overall well-being. With an incidence rate of nearly 7 in every 1,000 people worldwide, epilepsy is a condition that requires immediate attention. Studies suggest that individuals of Hispanic background are more prone to epilepsy, highlighting the need for specialized care and treatment. In this blog, we will delve into the distinct aspects of pediatric epilepsy, including its effects, diagnosis, and treatment options, emphasizing the advantages of early intervention. As we explore this critical topic, we'll also shed light on the expertise available at the New Jersey Pediatric Neuroscience Institute, ensuring the best care for children with epilepsy.

How does epilepsy differ between childhood and adulthood?

Epilepsy in children differs significantly from that in adults due to the developing nature of their brains. The malleability of a child's brain makes it more susceptible to permanent damage caused by recurrent seizures. These seizures can lead to developmental problems, affecting cognitive abilities, behavior, and psychological well-being. Unlike adults, children possess greater brain plasticity, enabling their brains to heal and reshape themselves with proper treatment, making early intervention crucial.

The Profound Effects of Persistent Epilepsy on a Child

Epilepsy can have profound effects on a child's brain, primarily due to its plasticity during the developmental stages. Seizures in children can impede the normal development of brain functions, resulting in cognitive delays, impaired social skills, psychological developmental problems, memory and language impairments, and an increased risk of sudden unexpected death in epilepsy (SUDEP). The impact of childhood epilepsy is more significant when seizures begin at an earlier age, potentially affecting long-term cognitive abilities and functioning.

The Advantages of Epilepsy Surgery in Children

While the prospect of brain surgery may seem daunting, epilepsy surgery has proven to be highly successful in treating pediatric epilepsy. Early intervention through surgery offers several advantages, making it a standard treatment for drug-resistant epilepsy (DRE) in children. With a success rate of nearly two-thirds, epilepsy surgery provides children with the opportunity to live a seizure-free life, preserving their cognitive abilities and ensuring a better quality of life.

Expertise at the New Jersey Pediatric Neuroscience Institute

When it comes to addressing pediatric epilepsy, seeking specialized care is of utmost importance. The New Jersey Pediatric Neuroscience Institute stands as a leading institution, offering specialized expertise and comprehensive care for children with epilepsy. Their team of dedicated specialists and state-of-the-art facilities provide the necessary resources to accurately diagnose and develop tailored treatment plans for each child. By partnering with the New Jersey Pediatric Neuroscience Institute, you can ensure your child receives the best possible care and support.

Conclusion

Pediatric epilepsy can have long-lasting effects on a child's mental abilities, behavior, and overall development. The plasticity of a child's brain presents both challenges and opportunities for effective treatment. Timely intervention, such as epilepsy surgery, can significantly improve outcomes and minimize disabilities. If your child is living with epilepsy, it is crucial not to delay seeking medical consultation from a specialized center, such as the New Jersey Pediatric Neuroscience Institute. By prioritizing early treatment, you can provide your child with the best chance for a bright and seizure-free future.