Pediatric Neurology?

Pediatric neurology or child neurology refers to a specialized branch of medicine that deals with the diagnosis and management of neurological conditions in neonates (newborns), infants, children and adolescents. The discipline of child neurology encompasses diseases and disorders of the spinal cord, brain, peripheral nervous system, autonomic nervous system, muscles and blood vessels that affect individuals in these age groups.

If a child has problems that involve the nervous system, a pediatric neurologist has the specialist training and knowledge to assess, diagnose and treat the child. The conditions dealt with by pediatric neurologists vary considerably, from relatively simple disorders such as migraine or cerebral palsy through to more complex and rare conditions such as metabolic disease or neurodegenerative disorders.

Examples of the types of conditions encountered by specialists in this field include:

• Genetic diseases of the nervous system
• Congenital metabolic abnormalities that affect the nervous system
• Congenital birth defects affecting the brain and spinal cord such as spina bifida
• Neurological developmental problems during childhood
• Childhood epilepsy
• Febrile seizures
• Movement disorders such as cerebral palsy
• Progressive neuromuscular conditions such as muscular dystrophy
• Abnormal mental development, speech disabilities and learning disabilities
• Autism spectrum disorders
• Behavioral disorders such as attention deficit hyperactivity disorder
• Headaches and migraine
• Hydrocephalus or excess fluid build-up in the brain
• Head injuries and their complications
• Brain tumors
• Hospice and palliative medicine
• Neuromuscular medicine
• Sleep disorders
• Vascular neurology
• Intellectual disability

Child neurologists are found in a variety of medical environments ranging from children’s hospitals through to outpatient practices, university medical centers and private clinics. They combine their understanding of diagnosis and treatment of the nervous system with expertise in childhood disorders and children’s special needs.Pediatric neurologists act as consultants to primary care physicians, who may refer children to the neurologists for specialist care. For children with long-term neurological ailments, the paediatric neurologist provides regular care and consultation.

Overall, about 40% to 50% of the patients treated in a typical pediatric neurology practice have epilepsy, while 20% have learning difficulties or developmental problems and 20% are suffering from headaches. The remainder are treated for rare or unusual conditions such as metabolic or genetic disease. Many centers are equipped with the specialized facilities and knowledge needed to treat very specific disorders such as rare neurodegenerative conditions, intractable epilepsy or pediatric stroke.

A number of pediatric neurologists choose careers in laboratory-based, clinical or translational research meaning the subspecialties of this field can attract individuals with PhD degrees, MD degrees or other forms of advanced training related to research. Advances in neurogenetics have meant this field has moved on from identifying single gene disorders to research into complex conditions such as Tourette’s syndrome or autism spectrum disorders. The opportunities available to both clinical and basic researchers in this field are continuing to expand.

In the USA, the training to become a pediatric neurologist involves four years of medical school, followed by 1 to 2 years of pediatric residency and at least three more years of residency training in adult and child neurology. Physicians then require certification from the American Board of Pediatrics and the American Board of Psychiatry and Neurology.