Surgery to improve walking ability in children with cerebral palsy

A recent research has discovered a surgical procedure that can improve walking ability in children with cerebral palsy. The procedure, known as selective dorsal rhizotomy, involves cutting some of the sensory nerves from the legs as they enter the spinal cord in order to relieve stiffness, improve mobility and reduce children's pain levels.

The operation is irreversible, and it had not previously been fully established whether it helped to improve children's quality of life, or what the longer-term effects were. Because of the lack of evidence of the benefits of the procedure, doctors in England established an innovative study that assessed eligible children with cerebral palsy before and after the operation.

Cerebral palsy is the name for a group of lifelong conditions that affect movement and coordination, caused by abnormal development or damage to the brain that occurs before, during or soon after birth. In the UK around 1,700 children, every year are born with cerebral palsy. Treatments include medicines to relieve muscle stiffness, pain relief, and physiotherapy to aid walking.

The team of researchers was instructed to find out whether selective dorsal rhizotomy did improve outcomes for these children with cerebral palsy. "NHS England has now decided that this procedure will be funded as a direct result of this innovative project. It's great to get this decision so that it will make a difference to patients," said one of the lead researchers of the study.

For the research, five centres were selected to perform selective dorsal rhizotomy, resulting in 137 children receiving the procedure. The researchers then collected and analysed data on patients' progress for two years after their operations.

Their results, showed the procedure benefited children by improving their movement, quality of life and levels of pain. They also found that there were no significant health risks to the children from the procedure.

"This procedure is for children with cerebral palsy who can walk but are having problems because the stiffness in their legs leads to pain and a lack of control over movement. Because it involves cutting nerves, the procedure is irreversible," the author explained.

Researchers claim this study shows objectively that the procedure does improve motor function, and doesn't have dangerous side effects. For some children with cerebral palsy and their families, this could really improve the quality of life and help children walk more easily and without the use of walking frames and other aids.  

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Swallowing and Nursing Problems in Children

Does your baby have trouble nursing? Are feeding sessions lasting longer than half an hour? Do they choke when nursing or eating? Do they spit up frequently? Cry at mealtime? Seem uncomfortable? Are they not gaining enough weight or maybe suffering from failure to thrive (FIT)? Does your baby or child refuse to eat? The following article is for those who have to deal with these problems.
When a baby is born, the concern for its proper eating is central to its care and constitutes an important element in the relationship between the mother and the newborn. Sucking, nursing, and swallowing are an important part of the baby's development and experience in life. With that being said, swallowing disorders are most common in newborns and infants. Sometimes they continue until the age of two and then they decrease considerably. As adults, their frequency rises again.

What characterizes breastfeeding and feeding a newborn and infant?

The struggle for optimal feeding and proper swallowing begins with birth and the subject is highly complex and requires special expertise. At the beginning of life, the baby does not eat but is fed. Try to imagine someone feeding you and not taking your organizational abilities into consideration. In addition, at this early stage of life, there is no dialogue, meaning that the baby can only cry but cannot explain their distress in words.
Infant swallowing disorders are characterized by the fact that a baby cannot describe their difficulty in swallowing, and cannot make any changes in the swallowing process on demand. The baby has difficulty timing their breathing and swallowing if anything goes wrong, therefore a swallowing disorder can be seen as a breathing disorder due to inhalation of food into the respiratory tract where choking and other breathing problems such as tightness in the chest can be experienced and also seen as a swallowing disorder.
In infants, difficulty in swallowing can cause energy loss with relative ease and disrupt life-threatening failure to thrive. In addition, infants and young children can develop an eating disorder and during this period of life, an eating disorder can simulate swallowing disorder and vice versa. Swallowing disorders are becoming more and more common because today, with the advancement of medicine, newborns who would not have survived in the past now do, such as premature babies, babies with congenital malformations, cerebral palsy, and more.

What happens today when there is difficulty in breastfeeding and feeding?

When there is difficulty in feeding a baby or small child, many are the counselors and plentiful are the pieces of advice. In practice, these consultations are not given out of knowledge and the ability to specifically diagnose the individual baby, but out of beliefs, despite the ignorance in this field. Too often the problem is explained by a milk allergy, tongue tie, or "reflux," which means that food goes back in the opposite direction from the stomach to the esophagus, and sometimes even to the pharynx.
Primary reflux may be due to a gastric esophageal disorder but in many cases secondary reflux, for example, improper ingestion can cause the baby to take in air while swallowing. Air pressure in the stomach can cause reflux and more. Unfortunately, the term "reflux" is constantly heard by non-professionals, as any problems swallowing or constant spit up is mistakenly diagnosed as a reflux. Many infants and babies who have been mistakenly diagnosed with reflux may have a different problem that can be properly resolved.

What are the common causes of swallowing difficulties in infants?

Common causes of swallowing difficulties are immaturity of the swallowing mechanism and anatomical variation that can lead to different ratios of tongue, jaw, and lips. For example, the way a child’s mouth is built may not fit the structure of the mother's nipples or of common bottle nipples. The synchronization between breathing and eating is more problematic, as a baby can have problems breathing through their nose, or finds it difficult to synchronize their breathing with their swallowing, and therefore, finds it difficult to compensate for the swallowing difficulties by changing the way they swallow as an adult would.
In many cases, there may be no visual evidence of congenital malformations or any other cause, but there is difficulty in swallowing and the baby spits up or refuses to eat. However, there are hidden defects that those who are not experts will not be able to see. In other cases, there are known problems such as neurological disorders including cerebral palsy, congenital malformations, some of which are known as cleft lip or open cleft palate. Often the solution given is changing nipples to one that fits better or diagnosis and treatment of eating disorders such as refusal to eat. The rate of newborns and infants suffering from swallowing disorders of varying degrees of severity is quite high and its implications for parents and babies’ health are very significant.

Who do you need to see to diagnose and treat babies and infants who suffer from swallowing problems?

Diagnosis of swallowing disorders requires specific knowledge and expertise in this field. Non-diagnosis can cause great frustration to the parents, unnecessary hospitalization, tube feeding, severe morbidity and even feeding through an opening in the abdominal wall directly to the stomach (enteral feeding or gastronomy feeding). Every year in all parts of the world, children are unnecessarily fed through gastrostomy, and only because of a lack of a professional body to diagnose a swallowing disorder and offer a correct solution. Swallowing and drinking properly requires coordination of the lips, tongue, mouth, palate, throat, upper esophagus, and neck. It should be remembered that swallowing disorders can be a symptom of serious and sometimes dangerous diseases of which early diagnosis is essential.

How are swallowing disorders diagnosed?

A trained ear, nose and throat doctor may examine the functions of the mouth while drinking and eating, as well as the pharynx and throat through professional observation and endoscopic video testing, i.e., fiber-optic inserted through the nose. Indeed, in many cases, this is sufficient to diagnose the problem and offer an effective solution. An ear, nose and throat doctor is assisted by a trained speech therapist, whose role is very important.

When the clinical examination and the endoscopic examination are not sufficient, it is necessary to examine the swallowing mechanism, and then a video-fluoroscopic test should be performed. This test is a radiographic test and is the only one that can demonstrate the structure and operation of the swallowing mechanism. This dynamic test enables the completion of the clarification and thus a dynamic three-dimensional imaging of the swallowing mechanism, which is highly recommended by swallowing specialists, is conducted using a radiographic scanning machine, during which the baby breastfeeds, drinks and eats calmly.

This test allows for different feeding methods, including various bottles and nipples in order to see which one is best for baby in terms of swallowing and prevention of inhaling food or drink into the respiratory tract. In babies and infants, breathing and swallowing are more closely related to each other than in adults, and the assessment of feeding in children is different than in adults. 

Every year babies who are fed artificially or need frequent hospitalization are diagnosed and an immediate solution is reached in many cases. Babies from the neonatal intensive care unit (NICU) fed through tubes are often seen by ENT’s and leave in their happy mother’s arms when the problem is diagnosed correctly, a solution to the problem is found, and a new, healthy and happy life can begin for parents and baby.

To conclude

Infantile and neonatal swallowing disorders are a first-rate medical problem and require a specific professional medical evaluation. Only in this way can a baby be correctly diagnosed and offered a real solution.

THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.                                                                                                                                                                                                        PS- THOSE INTERESTED IN RECIPES ARE FREE TO  VIEW MY BLOG-                                                                                           https://gseasyrecipes.blogspot.com/  

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Early intervention of Autism leads to fewer symptoms later

Early intervention for autism leads to fewer autism symptoms later in childhood. Unfortunately, autism diagnosis usually doesn’t occur until after three years of age. To improve time to therapy, researchers are looking for clues to diagnose autism as early as possible.

What’s new: In a large medical record study of 3,911 children with autism, researchers found that 38 medical conditions were associated with a future autism diagnosis. Medical conditions that showed the strongest link to autism included:

• Language delays
• Learning and cognitive disorders
• Global delays (significant delay in two or more areas of development)
• Motor delays
• Attention Deficit/Hyperactivity Disorder (ADHD)
• Anxiety disorders
• Cerebral palsy
• Epilepsy and recurrent seizures
• Disorders of the central nervous system

A combination of language delay with global delay most strongly correlated with an autism diagnosis. In total, the researchers identified 14 combinations of medical conditions that were associated with a future autism diagnosis.
Why it’s important: This study offers evidence that early life medical conditions could help doctors identify children who need close follow-up for autism assessment. Many of these medical conditions appear a year or more before autism symptoms become apparent.

  Autism Spectrum Disorder (ASD) is a group of conditions with common social and behavioral deficits. Trained specialists use behavioral tests to diagnose ASD. Although some ASD traits may appear as early as infancy, the average age for ASD diagnosis is about 4 years old. Despite increase in research funding and media focus, no molecular, genetic or brain imaging tests are available for diagnosing autism. 

At present, diagnosing ASD requires a comprehensive approach that includes systematic and structured observation of a child by trained clinicians. Guidelines for ASD diagnosis are set forth by various institutions.

There are two stages for diagnosing autism:

1. The first stage is screening, an easy-to-use, general method that identifies a potential risk for developing ASD.
2. The second stage is diagnostics, an in-depth examination that requires the assessment of cognition, linguistics, and motor skills by a qualified medical team to accurately diagnose the developmental disorder and the degree of the disorder.

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Being overweight during pregnancy makes the baby more susceptible to epilepsy

Being overweight or obese in the first trimester of pregnancy has been linked to a higher risk of bearing a child with epilepsy, researchers said on Monday.

The study was based on data from 1.4 million children in Sweden, and was published in the Journal of the American Medical Association (JAMA) Neurology.

Just how much a child’s risk of epilepsy rose was linked to how obese the mother was early in her pregnancy, said the findings led by Neda Razaz of the Karolinska Institutet in Stockholm, Sweden.

“Risk of epilepsy increased by 11% in children of overweight mothers,” whose body-mass index was between 25 and 30, said the study, which found that, of the 1.4 million children born between 1997 and 2011 in Sweden, 0.5% (7,592 children) were diagnosed with epilepsy through 2012. 

BMI is calculated based on a ratio of height and weight. The average range is generally 18.5-24.9.

Women who were obese, having a BMI of 30 to less than 35, saw a 20% increased risk of bearing a child with epilepsy compared to normal weight mothers.

For women with a BMI of 35 to less than 40, the risk rose 30%. And for those with extreme obesity, the risk was 82% higher than normal weight mothers.

Epilepsy is a brain disorder whose causes remain poorly understood.

The survey-based study did not delve into the causes of the apparently higher risk of epilepsy, which may include genetic and environmental factors.

Researchers speculated that being over weight or obese during pregnancy could lead to a higher risk of brain injury in infants, or that obesity-induced inflammation could affect neurodevelopment.

“Given that overweight and obesity are potentially modifiable risk factors, prevention of obesity in women of reproductive age may be an important public health strategy to reduce the incidence of epilepsy,” said the report.

A separate study in Denmark published last year by the American Academy of Pediatrics found that when women had a higher BMI before getting pregnant, their offspring faced a higher risk of cerebral palsy.
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Maternal recreational drug use linked to offspring brain birth defects

Mothers whose babies have brain defects at birth are more likely to have engaged in recreational drug use around the time of conception or during pregnancy. These are the findings of a new study led by researchers from University College London in the UK.

The research team, led by Dr. Anna David of the Institute of Women's Health at University College London, publish their findings in the journal PLOS ONE.

Past studies have associated recreational drug use in pregnancy with offspring birth defects, but Dr. David says many of these studies may be inaccurate as they have relied on self-reporting.

For this study, the researchers enrolled 517 mothers and tested samples of hair to determine their drug use around the time of conception and during pregnancy.

The team explains that when a person takes drugs, traces from the drugs accumulate in their hair as it grows. Since hair grows around 1 cm each month, the team took a 9-cm sample of hair from each woman to estimate their drug use for the previous 9 months.
 
Of the participants, 213 had a baby with a birth defect with possible links to recreational drug use, 143 had a baby with a birth defect not previously associated with recreational drug use, while 161 had a baby with no birth defect.

Drug use in pregnancy linked to brain underdevelopment, brain cysts in offspring

The team found that 77 (14.9%) of the women tested positive for the use of at least one recreational drug; 68 of the women had taken cannabis, 18 took cocaine, one took ketamine and one took MDMA (ecstasy).

The highest levels of recreational drug use were found around the time of conception but reduced by the first or second trimester of pregnancy. Approximately 50% of women who smoked cannabis, however, carried on using the drug into the second trimester.

The researchers found that 35% of the women whose baby was born with a brain birth defect - including brain cysts and brain underdevelopment - had engaged in recreational drug use at conception or during pregnancy, compared with 13% of women who had a baby without a birth defect.
 
Such brain defects at birth, the researchers say, are a major concern; they can have severe outcomes and lead to lifelong disorders, such as cerebral palsy.

Commenting on the results, Dr. David says:

"Our findings suggest a link between brain birth defects and recreational drug use in expectant mothers.

We were unable to identify significant links between specific drugs and brain birth defects. Therefore, I would discourage women trying to get pregnant and those in early pregnancy from taking any recreational drugs, including cannabis."

She adds, however, that only 20 of the mothers in the study had a baby with a brain defect at birth, therefore a larger study is warranted to confirm the findings - something she hopes will happen now that this study has indicated a link.

"The risks of alcohol and tobacco in pregnancy are relatively well-researched," she adds, "and we hope that research into drug use will catch up now that we have demonstrated its relevance to babies' health and development."

Last year, Medical News Today reported on a study suggesting that exercise during pregnancy can benefit offspring brain development.

 THIS IS ONLY FOR INFORMATION, ALWAYS CONSULT YOU PHYSICIAN BEFORE HAVING ANY PARTICULAR FOOD/ MEDICATION/EXERCISE/OTHER REMEDIES.








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Interactive health education - click on any disease and you can video/ text explanation.

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EXCELLENT READY REFERENCE FOR ALL COMMON DISORDERS

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Diseases and Conditions

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