The central nervous system is involved in several processes of the human body. The spinal cord and the brain are the two primary parts of the central nervous system. The majority of body functions rely on the brain, as well as the rest of the central nervous system. The brain assists in interpreting sensations, processing thoughts, and creating new memories. Speech, movement, and awareness also rely on a functioning brain.
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In newborns, the central nervous system still needs to develop fully. There are cases where anomalies occur with this system. These anomalies can interfere with the child’s development and sometimes even lead to the development of complications over the long term.
We take a look at the role of the central nervous system in children and the types of anomalies that can occur. We also consider both acquired and congenital conditions affecting the central nervous system and look at how rehabilitation can help patients with such conditions.
Disorders that Affect The Pediatric Central Nervous System
Several disorders and injuries can have a serious impact on the central nervous system. In some cases, a baby is born with anomalies in their central nervous system. In such a case, the child is diagnosed with a congenital disease. There are cases where problems with the central nervous system are only acquired later on as well.
Some disorders that have been linked to central nervous system anomalies include:
- Disorders that affect the immune system
- Metabolic diseases caused by genetics
- Infections in the central nervous system
- Trauma at the spinal cord or brain
- Structural defects present at birth
- The development of tumors
- Exposure to toxic chemicals
Anomalies with an infant’s central nervous system are often divided into two major categories. These include spinal cord anomalies, as well as brain anomalies. When considering brain-related problems, it is important to note that both acquired and congenital conditions need to be taken into account.
Spinal Cord Anomalies
The spinal cord is attached to the stem of the brain. It runs along the spine, toward the lower back region. Several nerves are found in the spinal cord. These nerves help to carry messages through throughout the body. The messages allow a person to control movements of the body, as well as provide a regulatory effect on multiple bodily functions.
Anomalies in the spinal cord can have serious implications for the body. Several complications and disorders of the spinal cord have been identified in newborns, infants, and other pediatric patients.
In the presence of signs related to spinal cord problems, imaging tests and other procedures may be performed on the pediatric patient. The condition that is often susceptible include:
- Neurodegenerative anomalies, such as spinal muscular atrophy
- Inflammatory conditions, including multiple sclerosis and transverse myelitis
- Congenital conditions, such as hereditary spastic paraplegia and tethered cord syndrome
- Vascular myelopathy
- Spinal cord tumors
- Infectious diseases affecting the spinal cord
It is important to note that traumatic injuries to the spinal cord should not be overlooked. Due to the developmental stage of the spinal cord, injury is more likely to occur in an infant when exposed to a hard fall or bump to the head, as well as the back.
Rehabilitation is often not needed for the condition itself. Long-term complications are noted among pediatric patients with central nervous system anomalies. Many of these complications are difficult to cope with for both the patient and the parents. Additional rehabilitation services may be provided to assist in the management of complications.
The rehabilitation process provided may include consistent 24/7 monitoring of the patient. This is generally the case with more severe types of complications and anomalies in the central nervous system. Nursing staff will be highly qualified in taking care of these toddlers and infants. They will also be experienced in knowing how to identify potential issues with the patient.
Comprehensive care is provided through an in-patient system. The pediatric patient is admitted to a medical facility for treatment and rehabilitation.
Depending on the severity of both the anomalies and the complications, there are many cases where kids can leave the facility and return home with their parents. Treatment is then taken from the medical facility toward the parent’s home – where the parents need to provide support to the child. Therapists and other healthcare providers who form part of the rehabilitation program will instruct parents on specific exercises and activities that need to be conducted at home.
The child also needs to be taken for a check-up with the healthcare professional overseeing their care regularly. Additional therapy sessions with a physical therapist, as well as other appropriate providers, are scheduled throughout the rehabilitation period.
The brain is often called the central processor for the human body. Problems with the brain, whether present at birth or an onset, later on, can have a serious impact on a child’s development. It may stunt their ability to experience growth in cognitive functioning. Anomalies by the brain may be caused by genetics, congenital problems, defects, as well as certain health conditions. Brain injuries also occur in cases where the baby is dropped, or they hit their head.
One study looked at data reported by a pediatric clinic. Data was collected for the period between 2002 and 2006. The study provided data on admissions of 16,520 pediatric patients throughout this period. Among those admitted, malformations and anomalies with the central nervous system were noted among 0.61% of patients.
In 9% of these cases, a lethal outcome, primarily resulting in death, were reported. Hydrocephalus and neural tube defects were the most commonly reported anomalies with the brain and central nervous system.
Neural tube defects are a relatively broad term used to describe a range of birth defects that affect the central nervous system—many of these causes’ adverse effects in the brain. Due to the central control function of the brain, multiple bodily processes may be affected.
The three primary types of neural tube defects associated with newborns include:
- Spina bifida
- Dandy-Walker Syndrome
Problems with brain development are the primary reason for these conditions to occur. The condition will be present at birth; thus, it is considered a congenital problem.
In newborn babies, there are a few signs that may signal the presence of brain anomalies. These must be noticed early on.
Parents should look out for problems like fluctuating body temperature, movements that are not considered normal, a soft spot on the head, and feeding difficulties. Fussiness in the baby is also a relatively common issue experienced when there are central nervous system anomalies.
A congenital brain defect may be associated with additional complications in the body. Associations have been made between these defects and cardiovascular disorders. A cleft palate and lip are more common in children with these defects, as well as poor vision, bowel problems, and ineffective bladder control. Defects affecting the gastrointestinal tract may also be noted.
Rehabilitation is often needed to assist in the management of the brain defect or anomaly but also following a surgical procedure. There are cases where the only solution to preventing life-threatening complications is for surgery to be performed on the newborn.
In cases where excess fluid is found within the skull, a decompression surgical procedure could pose useful. Shunts are sometimes used to assist in draining excess cerebrospinal fluid that accumulates in the presence of hydrocephalus.
There are surgical procedures that can assist in correcting defects experienced in the development of the skull as well.
In some cases, recovery can take a long period following the treatment.
The therapeutic services provided during rehabilitation help the pediatric patient recover faster and more efficiently. This process may include sessions of physical therapy for babies. At an older age, children may be provided with occupational therapy and related strategies to help in the development of their bodily functions.
Signs of Central Nervous System Anomalies
It can sometimes be difficult for parents to identify anomalies with an infant’s central nervous system. It is possible to overlook symptoms for something else. In some cases, the symptoms may not be an obvious sign of such anomalies.
This is why frequent check-ups, especially in the case of symptoms, should be an important part of a care program for infants and toddlers.
Parents are advised to take note of these symptoms:
- Muscle tremors and excessive stiffness
- Slurred speech
- Reduced muscle tissue
- Takes longer for the child to reach milestones in terms of development
- Movements and reflexes may change.
- Thea head’s size may be bigger or smaller than expected at the current age.
- Poor coordination
- Mood changes
- Issued identified with the infant’s consciousness
In older kids, particularly once they can speak, some have reported specific symptoms. This may include a tingling feeling in certain parts of the body. The inability to feel in some areas of the body may also be a sign of central nervous system damage or problems. Visual changes and headaches that are either severe or persistent should not be taken lightly as well.
It can be even harder to identify these symptoms in a newborn. One study5 reports a case where a baby, only ten days old, was admitted to a hospital. The child had completely lost their appetite. Parents were unable to feed the newborn. At the time of birth, the infant had weighed 5.14 pounds. One week after, he weighed 5.07 pounds. The child had experienced a drop in weight due to the reduced appetite. Jaundice developed three days following the child’s birth as well.
Following a series of tests, a central nervous system disorder was identified in the newborn baby. The disorder led to a loss of appetite and caused weight loss.
Rehabilitation Methods for Children with Central Nervous System Anomalies
Rehabilitation comprises of several treatment methods, often provided over the long term, to assist infants, toddlers, and young kids in the management of a central nervous system anomaly. The use of rehabilitation procedures can provide an effective reduction in the experienced symptoms while also working to strengthen muscle groups.
In some cases, rehabilitation is provided for more acute cases that can be treated through medication and appropriate therapies. A majority of cases where a central nervous system anomaly is identified leads to long-term care needs.
Physiatrists generally form part of the rehabilitation process. These healthcare providers will usually take charge of the rehabilitation treatment plan that is compiled for the pediatric patient.
Rehabilitation for an infant with an anomaly in the central nervous system depends on several factors. The age of the patient is always taken as a priority. Treatment and therapy options for newborns will mostly be limited compared to what is available to older children.
A physiatrist will provide a full assessment and order appropriate tests. The current identified symptoms will be taken into consideration.
The physiatrist may order further testing if conditions like cervical spondylotic myelopathy, transverse myelitis, and multiple sclerosis, among other conditions, are suspected. The tests ensure only the appropriate treatments are provided as part of a rehabilitation program for the infant.
Healthy development of the central nervous system contributes to better learning capabilities, thinking, and awareness among infants. Anomalies with the central nervous system can interfere with a child’s early development. In some cases, anomalies can result in adverse effects that remain present well after childhood. Rehabilitation implemented at the time of diagnosis help to provide early treatment. A continuous care and support program may help to enhance the pediatric’s quality of life and general functionality.
Cambridge Medical & Rehabilitation Center is the specialized provider for Long-term Care and rehabilitation services in the United Arab Emirates. With 2 main facilities in Abu Dhabi & Al Ain, which are designed in a hospital setup with a capacity of 90 beds each.
Cambridge provides an interdisciplinary clinical approach for Pediatric Rehabilitation. The best rehabilitation services are not only our goal but our ultimate objective is to customize the care plan for each patient and make sure that the patient’s family and their members are integrated into the treatment plan.
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