The Paediatric Neurology Service aims to improve the quality of care offered to children with acute and chronic neurological disorders affecting the brain, peripheral nerves and muscles.
Some of these disorders are very common and include headache, epilepsy, cerebral palsy, specific learning disorders and behavioural disorders e.g. autism, attention deficit hyperactivity disorder. Rarer disorders include brain tumors, neuromuscular disorders, acute non-traumatic encephalopathies and neurodegenerative disorders.
Neurology Clinic
There are daily clinic sessions from Monday to Friday, run by a team of doctors with support from physiotherapists, occupational therapists, speech therapists, paediatric epilepsy nurse educator, child psychologists and the medical social worker.
There is also co-ordination of care for children with chronic problems. We work closely with special schools for children with spasticity, multiple handicaps and learning disorders. At this daily clinic, we provide for the diagnosis and management of patients with neurological disorders, screening of neuro-developmental disorders and genetic counselling of relevant inherited neurological disorders.
Paediatric Clinic/Cerebral Palsy Clinic
This combined clinic provides comprehensive care for patients with spasticity who may require special seats at home or in school. Objective assessments are provided by the paediatric neurologist, the paediatric orthopaedic surgeons, the physiotherapists and occupational therapists and gait is objectively analysed at the Gait Analysis Laboratory in the Orthopaedic Diagnostic Centre, NUH. Children with cerebral palsy have a comprehensive review to decide on the most appropriate mode of treatment be it intramuscular bolutinum toxin injection for specific muscle groups, special orthotic devices, or tendon-release orthopaedic surgery.
Neuromuscular Clinic
This quarterly combined clinic provides comprehensive care for children and adolescents diagnosed with progressive neuromuscular conditions such as Duchenne muscular dystrophy and spinal muscular atrophy. Objective assessments are provided by the paediatric neurologist, paediatric pulmonlogiest, paedaitric orthopaedic surgeons, paediatric cardiologists, the phyiotherapists, occupational therapists and orthotists.
This allows an integrated review of all the associated complications that often arise in this group of patients, and allow a comprehensive management plan to be made.
Spina Bifida Clinic
This clinic is held once a month on a Saturday and aims to provide holistic care for patients with spina bifida or other forms of spinal cord dysfunction, who often encounter multiple problems with limb power and mobility, kidney and bladder problems and require special support from schools.
Our approach is a multidisciplinary one in that treatments involve the paediatric neurologists, paediatric nephrologists, paediatric urologists, paediatric orthopaedic surgeons and neurosurgeons, physiotherapists from NUH and the AWWA TEACH ME programme and the medical social worker.
Neuroscience Laboratory
We provide diagnostic services, comprising electroencephalograms performed by experienced technicians and interpreted by paediatric neurologists and epileptologists. Brainstem auditory-evoked response, and visual evoked potentials allows testing in children with suspected hearing or visual impairment respectively. Neuromuscular problems are also diagnosed and assessed here with nerve conduction studies and electromyograms.
Paediatric Epilepsy-Monitoring Unit (PMU)
The paediatric epilepsy-monitoring unit is designed specially for round-the-clock monitoring of patients diagnosed with epilepsy where more information is needed, or to clarify the nature of the patients' frequent spells/events. The patient (neonate, infant, child or adolescent) is admitted to the PMU to allow careful study of the clinical seizures or events.
The monitoring process involves continuous EEG recording with simultaneous video recording of the seizures. The analysis of these seizures or events shall enable an accurate diagnosis to be made, and allow formulation of management plans that include the possibility of surgical treatment for intractable seizures.
Research
We have an active clinical and basic research programme covering areas of epilepsy treatment and epidemiology, neurogenetic and neurometabolic disorders, botulinum toxin in childhood spasticity, encephalitis and other CNS infections and neuromuscular disease, in particular, the genetics and prenatal diagnosis of Duchenne's muscular dystrophy and spinal muscular atrophy as well as conditions such as neurofibromatosis type I.
