We have everything covered in our neuroscience program
We treat all forms of pediatric neurological illnesses and injuries, including complex conditions like brain tumors, brachial plexus injuries, spina bifida, and epilepsy. Our nationally ranked neuroscience program includes an ever-growing team of highly specialized neurologists and neurosurgeons using the most advanced pediatric technology and the latest research and innovations.
We are committed to answering all of your questions so you feel supported every step of the way. Here are some overviews of conditions we treat and services we provide.
Neurological conditions and services
A
Acoustic neuroma (also called vestibular schwannoma)
Arachnoid cysts
Arteriovenous malformation
Astrocytoma
An astrocytoma is a type of glioma (a tumor that originates in the brain or spinal cord) that forms in star-shaped cells called astrocytes. Astrocytomas can be benign (noncancerous) or malignant (cancerous). They are the most common type of brain tumor, accounting for more than half of all central nervous system (CNS) malignancies.
Astrocytomas are classified by grade and location, which is determined by how quickly the tumor grows, the abnormality of the cells, and the location in the CNS. Imaging studies like CT scans and MRIs can determine size, location and spread, but a surgical biopsy may be needed to further classify certain astrocytoma subtypes. Treatment for a child with an astrocytoma varies depending on the tumor, but it typically includes surgery, radiation therapy and chemotherapy.
B
Benign enlargement of the subarachnoid spaces
Brain malformations
Brain and spinal cord tumors
Brainstem glioma
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand.When a birthing baby’s head is stretched away from the shoulder, the brachial plexus nerves can get injured. Brachial plexus injuries occur during birth in 1 to 2 births per 1,000, with larger babies or babies in breech position at an increased risk. Other pediatric brachial plexus injuries are often due to sports injuries, falls or accidents.
Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function. A neurosurgeon might perform a nerve graft or transfer, a muscle transfer, or a tendon transfer to repair function, reduce pain and numbness, and improve movement and control.
C
Cavernous malformation
A cavernous malformation is a rare, abnormal cluster (often in the shape of a mulberry) of small blood vessels in the brain or spinal cord that may leak blood. Bleeding in the brain and spinal cord can be serious in severe cases – causing a hemorrhage that can lead to seizures, paralysis, stroke, etc. – but most cavernous malformations are non-life-threatening.
Symptoms may include balance issues, headache, seizure, vision problems, slurred speech, weakness or numbness. Any time a child is experience concerning symptoms they should see a health care professional for care.
Chiari malformation
Chiari malformation happens when the lower part of the brain, called the cerebellum, pushes into the spinal canal. This can cause symptoms including:
- Headaches, especially after sneezing or coughing
- Balance problems, dizziness, poor hand coordination
- Neck pain, numbness and tingling in hands and feet
Doctors don’t know exactly what causes Chiari malformation. A baby can be born with Chiari malformation, it can develop in the first few years of life, or it can happen from trauma, infection, or other medical problems. Chiari malformation can run in families, so it may have a genetic cause. Many Chiari malformations are found by accident and do not cause symptoms or need surgery. Sometimes surgery is recommended to relieve pressure in the affected area.
Cerebral palsy
- Spastic – People with spastic CP can’t relax their muscles or the muscles may be stiff; 80% of people with CP have spastic CP.
- Athetoid (or dyskinetic) – This type of CP causes involuntary muscle movements.
- Ataxic – This type of CP causes problems with balance and coordination.
- Mixed – Some people have symptoms of more than one type of CP. The most common type of mixed CP is spastic-dyskinetic CP.
Cerebellar Juvenile Pilocytic Astrocytoma (JPA)
Compression fractures
- Severe back pain that does not go away after taking pain medicines
- Loss of feeling or “pins and needles” in the legs or feet
- Trouble controlling his or her bladder or bowels
Concussion
Craniopharyngioma
A craniopharyngioma is a rare, slow-growing, benign (noncancerous) brain tumor that grows at the base of the brain near the pituitary gland and the hypothalamus. A tumor in this location can affect the cranial nerves (vision) and endocrine system (hormonal functions of the body).
Treatment usually starts with surgery to remove as much of the tumor as safely possible. Radiation or chemotherapy might be used after surgery to treat any remaining tumor cells. The prognosis is typically very good after treatment.
Craniosynostosis
Craniosynostosis is a condition where the bones of the skull fuse too early after birth. This can happen for unknown reasons or due to genetics. If not treated, it can cause developmental delays because of pressure on the growing brain.
Treatment for craniosynostosis involves our craniofacial neurosurgical team opening the sutures of the skull to reposition and shape the soft tissues of the head. This allows the brain to grow and helps achieve a better head shape.
D
Dermoid and epidermoid cysts
Developmental delays
When a child’s development lags behind their peers of the same age, it is called a developmental delay. This could include late mastery of language, motor and self-help skills, cognitive skills, social skills, and emotional skills. It’s important to reach certain milestones at specific ages to make sure the child is reaching their full potential. When developmental delays are detected, support services and treatments including occupational, speech, and physical therapy can be very beneficial.
Developmental regression
Disk herniations
A disk herniation happens when the soft disk between the individual bones in the spine (vertebrae) is pinched or injured. When a disk ruptures, a jelly-like material comes out of it and causes pain, and possibly numbness or tingling in the arms or legs. In severe cases, it can make the arms or legs weak or cause problems with bladder or bowel movements.
Most disk herniations do not need surgery, especially in young and healthy children. However, if the symptoms are very bad or do not get better with other treatments, a surgery called a diskectomy may be needed.
Down syndrome
Down syndrome is a genetic condition where a person is born with an extra copy of chromosome 21, giving them a total of 47 chromosomes; most people have 46. The extra chromosome changes the way the body and brain develop, causing physical, cognitive and behavioral symptoms. Not all people with Down syndrome have the same symptoms and the severity is different for every person.
There is no cure for Down syndrome, but treatments and support services for the child and their family can help everyone thrive physically, mentally, and emotionally to reach their full potential.
Dysembryoplastic neuroepithelial tumor (also called ganglioglioma)
A dysembryoplastic neuroepithelial tumor (DNET) – also known as a ganglioglioma – is a very rare, slow-growing, typically benign (noncancerous) brain tumor associated with seizures in kids and young adults. These tumors are a mixture of neuronal cells and glial cells, and they are mainly located in the temporal or frontal lobe.
Surgery is the treatment for this type of tumor, and complete removal is associated with a very high cure rate. Seizures are often controlled with removal of the tumor.
Dystonia
E
Encephalocele
An encephalocele is a rare birth defect that occurs when the skull doesn’t close over the brain during fetal development. The gap in the skull allows brain tissue to come out of the skull opening, causing a bulge under the skin. This can look like a small balloon coming out of the child’s head; it can happen anywhere on the head.
Each year, approximately 375 babies are born with the condition in the U.S. The condition can range from mild to life-threatening. Surgery to treat this condition involves repairing the skull and removing the brain tissue that grew outside of the skull, which is usually no longer functional. Children often need more than one surgery and other care to treat this condition.
Ependymoma
An ependymoma is a rare, slow growing, typically benign (noncancerous) tumor that begins in the ependymal cells, which line both the hollow cavities of the brain and the canal containing the spinal cord. The tumor can produce headache, nausea and vomiting by obstructing the flow of cerebrospinal fluid (CSF). This obstruction may also cause hydrocephalus (build-up of CSF in the cavities in the brain).
Treatment for an ependymoma is surgery to remove as much of the tumor as possible without
causing damage to the normal brain. Complete removal is associated with a favorable prognosis.
Epilepsy
Epilepsy is a chronic brain disorder that causes abnormal electrical activity in the brain called seizures. It is usually diagnosed after a person has had at least two seizures that were not caused by another medical condition. Epilepsy can start at any age, but it most often begins in childhood or in people over the age of 60. There are different types of seizures and epilepsy.
Many people with epilepsy can be successfully treated with medications, lifestyle changes, and dietary changes. There are also several advanced treatments and surgical options that can significantly improve seizure control and quality of life, including placing a vagus nerve stimulator (VNS) or using robotic-assisted stereotactic EEG (sEEG) leads to remove the part of the brain causing seizures. Other advanced epilepsy procedures include lobectomy, corpus callosotomy, and hemispherectomy.
F
Flat head syndrome (also called positional plagiocephaly)
Flat head syndrome is a condition where a baby’s head is flattened due to prolonged time spent in the same position. It can happen if a baby sleeps in the same position for long periods of time, or if they have neck muscle issues that cause them to favor turning their head to one side.
Flat head syndrome usually gets better on its own, and it can also help to change the baby’s sleep position, hold the baby often in different positions, add more supervised tummy time, and encourage the baby to turn their head to look at toys. Helmet therapy is a treatment option to assist with correcting the shape of the baby’s head.
G
Glioma
A glioma is a type of brain tumor that starts in the brain or spinal cord from glial cells. Gliomas can be benign (noncancerous) or malignant (cancerous), and low-grade (slow growing) or high-grade (fast growing). There are many different types of gliomas; most gliomas are treated with surgery first, followed by radiation and/or chemotherapy.
H
Head trauma or head injury
A head injury or trauma is an injury to the scalp, skull or brain. Head injuries range from mild to severe and every head injury should be carefully considered. Kids that have been hit in the head and have a suspected concussion should go to the emergency room for evaluation and possible imaging on the day of the injury.
Hydrocephalus
Hydrocephalus is a build-up of cerebrospinal fluid (CSF) in the cavities in the brain (ventricles). The extra fluid puts pressure on the brain tissues and can cause headaches, vomiting, vision problems, developmental delays, and worse. Hydrocephalus can be present from birth (congenital) or caused by infections, brain tumors, or head injuries (acquired). If not treated, it can cause high pressure in the brain and symptoms like headaches, vomiting, or sleepiness.
The usual treatment for hydrocephalus is to place a shunt to drain the CSF in the brain to another part of the body. In some cases, patients may be good candidates for an endoscopic third ventriculostomy (ETV), a surgical procedure that creates a bypass for CSF in the brain.
Hyperhidrosis
I
Intellectual disability
Intellectual disability (ID) is a neurodevelopmental condition that causes difficulty thinking and understanding, challenges with communication, social participation and daily life activities. Causes include genetic conditions, birth defects, disease, injury or other problems in the brain. There is no cure for ID, but kids with ID can learn skills and be supported with special education, behavioral, speech, physical and occupational therapy, among many other services, to live their lives to the fullest.
Intracranial and intraspinal cysts
Intracranial and intraspinal cysts are sacs filled with fluid that can develop in the brain and the spinal cord. The most common type of this kind of cyst is called an arachnoid cyst, which forms between the membranes surrounding the brain and spinal cord. It is usually filled with cerebrospinal fluid. They are usually benign (noncancerous) and slow growing.
Many cysts do not cause symptoms. Depending on the size and location, symptoms can include headaches, nausea, seizures, vision problems, balance issues, or neurological deficits depending on the affected area. Surgery to remove the cyst depends on its size, symptoms, and location in the central nervous system.
Intracranial germ cell tumor
A germ cell is a cell that develops into a reproductive cell, (which is an egg in females and a sperm in males) and migrates to the reproductive organs. When germ cells don’t migrate correctly during embryonic development, they can get trapped in the brain. If the germ cells form a tumor, it’s called an intracranial germ cell tumor.
There are two types of intracranial germ cell tumors: germinomas and non-germinomatous. A germinoma is a rare, malignant (cancerous), slow-growing germ cell tumor that is usually treated with chemotherapy and radiation. Non-germinomatous germ cell tumors release chemicals into the bloodstream and spinal fluid and require a more intensive treatment plan.
Intracranial hypotension
Intracranial hypotension (IH) is a condition that happens when there is a loss of cerebrospinal fluid (CSF) and a decrease in pressure within the brain. Symptoms can include headache that worsens when sitting up, nausea, vomiting, double vision, difficulty concentrating, and sensitivity to light or sound. Causes of IH can include a congenital defect, trauma, shunt procedure, or diagnostic test like a spinal tap.
Intraventricular hemorrhage
An intraventricular hemorrhage (IVH) is bleeding in or around the spaces in the brain that contain the cerebral spinal fluid (the ventricles). IVH is most common in premature babies weighing three pounds or less and is most likely to happen within the first three days after birth. The tiny blood vessels in a premature baby’s brain are very fragile and easily rupture.
J
Intracranial germ cell tumor
A germ cell is a cell that develops into a reproductive cell, (which is an egg in females and a sperm in males) and migrates to the reproductive organs. When germ cells don’t migrate correctly during embryonic development, they can get trapped in the brain. If the germ cells form a tumor, it’s called an intracranial germ cell tumor.
There are two types of intracranial germ cell tumors: germinomas and non-germinomatous. A germinoma is a rare, malignant (cancerous), slow-growing germ cell tumor that is usually treated with chemotherapy and radiation. Non-germinomatous germ cell tumors release chemicals into the bloodstream and spinal fluid and require a more intensive treatment plan.
Intracranial hypotension
Intracranial hypotension (IH) is a condition that happens when there is a loss of cerebrospinal fluid (CSF) and a decrease in pressure within the brain. Symptoms can include headache that worsens when sitting up, nausea, vomiting, double vision, difficulty concentrating, and sensitivity to light or sound. Causes of IH can include a congenital defect, trauma, shunt procedure, or diagnostic test like a spinal tap.
K
Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
L
Leukodystrophies
Leukodystrophies are a group of rare genetic conditions that affect the white matter of the brain and spinal cord (called myelin). Myelin insulates and protects nerve cells so they can transmit signals to keep the nervous system functioning properly. Leukodystrophies disrupt the growth or maintenance of myelin.
There are more than 50 types of leukodystrophies; some leukodystrophies are present at birth, and some may not cause symptoms until later in life. Symptoms vary by type and can include problems with movement, speaking, vision, hearing, mental and physical development, seizures, cognitive delays or regression.
M
Macrocephaly
Macrocephaly is a rare condition where the child’s head circumference is larger than average. Children are typically diagnosed with macrocephaly when their head circumference is greater than the 98th percentile of kids of the same age and sex. It can be harmless, or it can be a sign of a serious medical condition (e.g., fluid inside or outside of the brain). About 2% to 5% of the U.S. population is diagnosed with macrocephaly.
Medulloblastoma
A medulloblastoma is a malignant (cancerous), fast-growing brain tumor that occurs in the cerebellum, the part of the brain that controls balance and coordination. Treatment usually starts with surgery to remove as much of the tumor as safely possible. Radiation, chemotherapy, and clinical trials are also treatment options.
Meningioma
A meningioma is a slow growing, typically benign (noncancerous) tumor in the meninges, the layers of tissue that cover the brain and spinal cord. Meningiomas can compress brain tissue and affect cranial nerves and blood vessels as they grow, so surgery to remove the tumor might be necessary. Radiation therapy is also used to treat meningiomas.
Metabolic disorder
A metabolic disorder in a child occurs when their body has trouble processing nutrients like fats, proteins and sugars. These disorders are often genetic and can be passed down through families, but obesity can also cause metabolic disorders in older children.
When the body cannot break down nutrients it can lead to a buildup of toxic substances that can severely impact the developing brain, causing neurological problems like developmental delays, seizures, muscle weakness, and altered consciousness. This can cause symptoms like poor feeding, sleepiness, vomiting, and abnormal body odor. Common pediatric metabolic disorders include phenylketonuria (PKU), maple syrup urine disease (MSUD), and fatty acid oxidation disorders.
Microcephaly
Microcephaly is a rare birth defect that causes a baby’s head to be smaller than expected for their age and sex. It can be caused by several factors up to two years after birth including:
- A genetic blood disorder
- The fetus’ brain did not develop properly during pregnancy
- Exposure to harmful substances during pregnancy, including drugs and/or alcohol used by the mother or exposure to chemicals, radiation, or certain viruses
- The baby’s brain stopped growing properly after birth
Children with microcephaly will have varying degrees of developmental problems ranging from very few challenges to cognitive development issues, coordination challenges, hearing or vision loss, seizures, or other problems associated with brain abnormalities.
Mitochondrial disorder
Intracranial hypotension (IH) is a condition that happens when there is a loss of cerebrospinal fluid (CSF) and a decrease in pressure within the brain. Symptoms can include headache that worsens when sitting up, nausea, vomiting, double vision, difficulty concentrating, and sensitivity to light or sound. Causes of IH can include a congenital defect, trauma, shunt procedure, or diagnostic test like a spinal tap.
Movement disorders
Pediatric movement disorders (PMDs) are neurological conditions that affect a child’s movement quality, speed, ease, and fluency. They can be mild or severe and can occur independently or as a symptom of another condition. Symptoms can include repetitive and predictable movements, sometimes uncontrolled, like body rocking, hand flapping, repetitive blinking, odd facial movements, grunting noises, or hair twirling. Some examples of PMDs include tic disorders, tremors, myoclonus, ataxia, spasticity, parkinsonism, and dystonia.
Moyamoya disease
Moyamoya disease is a condition that causes the arteries in the brain to narrow, which limits blood flow to the brain. This increases the risk for seizures, stroke, and cognitive problems. The brain responds by growing new blood vessels to compensate, which appear as a wispy, smoke-like pattern on an X-ray. This is where the disease gets its name, which means “puff of smoke” in Japanese. Surgery is necessary to treat or bypass the narrowed arteries and create a new blood supply for the affected areas of the brain.
Musculoskeletal system
The musculoskeletal system refers to the muscles, bones, tendons, ligaments, joints, and cartilage that provides the body’s structure, support, and ability to move. Musculoskeletal health is important for a person’s overall health and quality of life.
N
Neuromuscular disorders
Neuromuscular disorders are conditions that affect the muscles and nerves, causing weakness, spasms, twitching, and pain. They can be caused by a number of factors, including genetics, autoimmune disorders, or spontaneous gene mutations.
Neonatal neuro-intensive care unit
The team of specialists in the neonatal neuro-intensive care unit (NICU) focuses on improving outcomes in very premature babies and all babies at-risk for neurological damage. Continuous electroencephalogram (EEG) monitoring allows the team to evaluate needs and respond quickly to issues.
Neurocutaneous syndromes (also known as phakomatoses)
Neurocutaneous syndromes are a group of rare, lifelong conditions that affect the brain, spinal cord, organs, skin, and bones. Each disorder has different symptoms, but common problems include tumors, hearing loss, seizures, and developmental issues. Common neurocutaneous syndromes that affect kids are:
Neurodevelopmental disorders
Neurodevelopmental disorders (NDDs) are a range of conditions that affect the brain and neurological system and can impair learning at any age. NDDs currently include autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), specific learning disorders (SLD), intellectual disabilities, communication disorders, and movement disorders. Treatments for NDDs vary greatly and often include a combination of medications, behavioral, occupational, physical, and speech therapy, and psychological counseling.
Neurofibromatosis type 1
Neurofibromatosis type 1 (NF1) is a genetic disorder that can affect multiple body systems, including the skin, eyes, nervous system, and bones. Some common symptoms include multiple light brown café-au-lait spots on the skin, benign (noncancerous) tumors on the skin surface or just under it, freckles under the arms or in the groin area, and others. There is no cure for NF1, but most cases are not severe and do not require treatment or other clinical support. Problems caused by NF1 are treated on a case-by-case basis.
Neurology
Neurology is a medical specialty that focuses on diagnosis, treatment and management of disorders of the nervous system, which includes the brain, nerves, muscles and blood vessels.
Neuropathy
Neuropathy is a nerve problem that causes pain, numbness, tingling, swelling, or muscle weakness in different parts of the body. There are more than 100 types of neuropathies, each with its own symptoms and prognosis.
Neuropsychology and psychology
Neuropsychology is a branch of psychology that studies the relationship between the brain and nervous system, and how they affect behavior and cognition. Neuropsychologists focus on how brain function affects behavior, including neurobehavioral disorders, cognitive processes, and brain disorders. Psychologists focus on how emotions and experiences affect mental and behavioral health.
Neuro-oncology
Neuro-oncology is a neuroscience subspecialty that focuses on the diagnosis, treatment, and management of brain and spine tumors, as well as the neurological complications of cancer.
Neurosurgery
Neurosurgery is a medical specialty that involves performing procedures to treat conditions affecting the nervous system, including the brain, spinal cord, and peripheral nerves. Some common neurosurgical procedures include craniotomy, laminectomy, and peripheral nerve surgery.
Neurotrauma (brain and spine injury)
Neurotrauma includes injuries to the brain, spine, spinal cord or nerves as the result of an external force, like a car accident, contact sports, and falls. The resulting condition might include a concussion, traumatic brain injury (TBI), skull fracture, spinal column fracture, or spinal cord injury (SCI).
These injuries are almost always an emergency situation that require immediate treatment. Neurotrauma injuries will typically cause headaches, nausea or vomiting, fatigue or drowsiness, problems with speech, dizziness or loss of balance. It is important to seek medical help right away. Depending on the nature of the injury, one of the following surgical procedures may be needed: craniotomy/craniectomy, spinal fusion, and/or cord decompression.
Noonan syndrome
Noonan syndrome is a genetic condition present from birth that can cause a variety of health issues and distinctive physical features. Some of the more common health issues include heart problems, slow weight gain, vision and hearing problems, easy bruising and bleeding, and slow growth/short height. Common physical features include a broad forehead, widely spaced and light-colored eyes, low-set ears, short neck, small lower jaw, and short height.
Most people with Noonan syndrome have normal intelligence, but some may have special educational needs or intellectual disability. With needed care, most children with Noonan syndrome will grow up and function normally in adulthood.
Nutrition
Children’s Minnesota provides specialized medical nutrition therapy to patients with a wide range of conditions, including cancer and blood disorders, epilepsy and many other neuroscience conditions.
O
Optic pathway glioma
An optic pathway glioma (OPG) is a slow growing, typically benign (noncancerous) brain tumor that forms in or around the optic nerve, which connects the eye to the brain. As the tumor grows, it presses on the optic nerve and causes vision to worsen. Treatment and management of these tumors can be complex because of the location. Surgery isn’t always the preferred treatment; chemotherapy and radiation are often used successfully to treat these tumors.
P
Pituitary and neuroendocrine tumors
A pituitary tumor is an abnormal growth of cells in the pituitary gland, a small gland at the base of the brain that controls many other glands and hormones in the body. They are usually benign (noncancerous) and slow growing. However, they can cause some problems by producing too much or too little of certain hormones.
Neuroendocrine tumors (NETs) are rare tumors that can be cancerous or noncancerous and develop in the neuroendocrine system, which is made up of nerve and gland cells that produce and release hormones into the bloodstream. NETs can affect many organs, including the stomach, lungs, pancreas, and thyroid.
Pituitary and neuroendocrine tumors may be removed with surgery, or growth may be controlled with medications or radiation therapy. Hormone levels can be managed with medicine. There are many types of pituitary and neuroendocrine tumors, and not all of them cause symptoms, so health care providers will recommend the right care approach for each patient.
Q
Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
R
RASopathies
RASopathies are a group of rare genetic conditions caused by mutations in genes of the RAS-MAPK pathway, which is one way cells in the body communicate. Abnormalities of this pathway cause one of several different conditions including: cardiofaciocutaneous (CFC) syndrome, Costello syndrome (CS), Legius syndrome (LS), neurofibromatosis type 1 (NF1), and Noonan syndrome (NS).
These syndromes share many clinical features such as distinct facial features, developmental delays, cardiac defects, growth delays, neurologic issues, and gastrointestinal difficulties. While these individual syndromes are rare, as a group the RASopathies are among the most common genetic conditions.
S
Scoliosis
Scoliosis is a chronic condition that causes an abnormal sideways curve of the spine, usually in the shape of an S or C. It most often develops in children between the ages of 10 and 15. Treatment depends on the severity and location of the curve and how much more the child is expected to grow. Mild cases often don’t require treatment; more severe cases may require bracing or surgery.
Seizure
A seizure is a surge of abnormal electrical activity in the brain that can cause a change in behavior, movement, or consciousness. The most common symptoms are a temporary loss of consciousness and uncontrollable movements. Other symptoms can include staring into space, unusual thoughts or sensations, and stiffness or limpness.
When someone is having a seizure, it is helpful to lay them on the floor or ground on their side. Clear the area around them and try to cushion their head. Remove any clothing or jewelry that could be a hazard. Stay with them until they recover and medical help arrives.
Most seizures last less than two minutes and stop on their own. A child could have one seizure and never have another one. When someone has frequent seizures, they could be diagnosed with epilepsy. Any time someone has a seizure unexpectedly they should be seen by a medical professional, even if they have had one before.
Selective dorsal rhizotomy (with single- or multi-level laminectomy)
Selective dorsal rhizotomy (SDR) is a spinal surgery that can permanently reduce leg spasticity in children with cerebral palsy. The procedure cuts some of the sensory nerves between the legs and spinal cord. SDR can improve mobility, walking, balance, sitting and standing posture, and reduce pain.
A multi-level laminectomy offers a full view of the nerve roots to be cut, with a trade-off of having more pain and a longer recovery after surgery. The single-level laminectomy only removes one bone that does not need to be put back in place, with often a shorter recovery period. Both approaches have benefits and risks; both options are offered by our neurosurgery team when surgery is necessary.
Sleep apnea
Sleep apnea is a sleep disorder that causes breathing to repeatedly stop or become shallow during sleep. There are two main types of sleep apnea:
- Obstructive sleep apnea (OSA) is the caused by soft tissue in the throat relaxing and blocking airflow. This is the most common type.
- Central sleep apnea (CSA) is caused by the brain not sending the right signals to the muscles to breathe.
Surgery to remove tonsils and adenoids is a common treatment for obstructive sleep apnea in kids. Sleep apnea and other sleep disorders can be diagnosed during a pediatric sleep study.
Spasticity
Spina bifida
Spina bifida is a birth defect in which part of the spine does not form normally before birth, leaving an opening in the back. As a result, the spinal cord and nerves may be damaged. There are three types of spina bifida:
- Spina bifida occulta – This is the mildest type. Most children with this form don’t have any problems, though some may develop symptoms as they get older.
- Meningocele – In this type, the membranes that cover and protect the brain and spinal cord (called the meninges) push through the opening in the back, forming a sac (called a meningocele). Since the spinal cord is not involved, there is little or no nerve damage and disability is usually mild.
- Myelomeningocele (MMC) – This type is the most common and most severe. It happens when the meninges and the spinal cord push through the opening in the back. This causes nerve damage and is associated with more severe disabilities.
Sometimes MMC can be treated prenatally through a surgical procedure known as myelomeningocele (MMC) repair to close the spine and stop injury to the exposed nerves. More recent surgical advances make it possible to perform some of these procedures with a less invasive fetoscopic MMC repair, which eliminates the need for a large incision in the uterus. This procedure reduces the risks associated with open fetal surgery, such as rupture of the uterus, and allows the mother the ability to have a vaginal delivery.
Every person with spina bifida has different abilities and their medical and daily care needs can vary tremendously. Surgery, physical and occupational therapy, medication, and other therapies are used to treat the effects of spina bifida and may be needed throughout a patient’s life.
Spine and spinal cord trauma
A spinal cord injury (SCI) is damage to the bundle of nerves that sends and receives signals between the brain and the rest of the body. SCIs can cause temporary or permanent changes in movement, strength, feeling, and other body functions.
Spine and spinal cord injuries range from mild to severe and every injury should be carefully considered. Kids that have been hurt in the spine area should go to the emergency room for evaluation and possible imaging on the day of the injury.
Spondylolysis and spondylolisthesis
Spondylolysis is a stress fracture in the small ridges of the spine bone that connect the vertebrae called the pars interarticularis (pars). It can be present from birth, caused by an injury, or repetitive stress from sports like gymnastics and weightlifting. It can also develop gradually during normal growth. Spondylolisthesis is a condition that happens when one vertebra slips out of place and presses on the vertebrae below it. It’s usually caused by spondylolysis or general wear and tear in the spine.
Treatment depends on the patient’s symptoms and whether there is instability in the spine or risk of injury. Usually, treatment is conservative with medications, physical therapy, bracing, and activity changes. In rare cases, surgery is needed to fuse the spine and stabilize the defect.
Stereoelectroencephalography (SEEG)
Stereoelectroencephalography (SEEG) is a minimally invasive surgical procedure that involves implanting electrodes in the brain to help identify the exact source of seizures. The electrodes remain in the skull while the child is monitored for seizure activity; the procedure requires a 7-to-10-day in-patient stay. Then the electrodes are removed and the data that was collected is used to determine if surgery is an option to treat the seizures.
If surgery proceeds, another advanced technology called ROSA, a robotic operating surgical assistant software, will be used to perform the brain surgery. Children’s Minnesota’s Level 4 Pediatric Epilepsy Center is the only program in the state that combines the sophisticated technology of SEEG and ROSA.
Stroke
A stroke is a medical emergency that occurs when a blood vessel in the brain bursts or is blocked, preventing blood from reaching brain cells. Brain cells need oxygen and nutrients from blood to function, so when blood flow is cut off, cells die within minutes.
Pediatric strokes are rare; researchers say there are about 1 to 2 childhood stroke cases per 100,000 annually. They tend to impact young people with heart disorders, blood clotting disorders, congenital conditions, or those who have injuries from birth. Many children who have a stroke tend to recover fully.
Sturge-Weber syndrome
Sturge-Weber syndrome (SWS) is a rare neurological disorder with a port-wine facial birthmark as a common symptom. SWS also commonly causes angiomas, noncancerous tumors made up of small, dilated blood vessels. These angiomas appear on the brain and typically on the same side as the birthmark. Excessive blood vessel growth can cause abnormal brain functioning, including seizures, developmental delays, and other neurological problems. Many kids with SWS also have glaucoma in the eye that is on the same side of the face as the birthmark. There is no cure for SWS; treatment depends on the problems experienced by the individual patient.
Subdural grid placement surgery
Subdural grid placement surgery is a procedure that involves placing a grid of electrodes on the brain to help identify the source of seizures. The purpose of this procedure is to help pediatric neurosurgeons create a plan for a second surgery that removes areas of the brain causing seizures.
Syringomyelia and syrinx
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Tethered spinal cord
A tethered spinal cord means the spinal cord is stuck to the inside of the spinal canal and cannot move freely. This condition is common in children with spina bifida but can occur in others as well. If left untreated, it can cause nerve damage, loss of movement, and inability to control the bladder or bowels. Tethered spinal cord surgery will reduce or remove the scar tissue that prevents the spinal cord from moving freely.
Thyroid tests
The thyroid gland produces hormones that help the body do many things including get energy from food, grow, and go through sexual development. The pituitary gland makes a thyroid stimulating hormone. Then the pituitary gland and the thyroid gland send messages back and forth to each other about how much hormone to make to keep the levels normal. If either of these glands aren’t working properly, clinical tests are necessary to figure out why.
Tuberous sclerosis complex
Tuberous sclerosis complex (TSC) is a rare genetic disease that causes benign (noncancerous) tumors in the brain and other areas of the body, including the spinal cord, nerves, eyes, lung, heart, kidneys, and skin. TSC can also cause seizures, developmental delays, and mental disabilities. Most people with TSC have skin-related symptoms like ash leaf spots (less melanin), confetti marks (freckles with lighter skin around them), and fibromas (noncancerous tumors) on the face and under fingernails and toenails.
Tuberous sclerosis isn’t curable, but it’s often treatable. The treatment approaches usually depend on the types of symptoms.
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Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
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Vascular malformations
There are different types of blood vessel problems in the brain and spinal cord. The most common ones are:
- Arteriovenous malformation (AVM) – An abnormal tangle of blood vessels that connects arteries directly to veins, bypassing the capillary system, which can damage tissue and rupture, causing bleeding into the brain or spinal cord.
- Cavernous malformation – An abnormal cluster (often in the shape of a mulberry) of small blood vessels in the brain or spinal cord that occasionally leak slowly or bleeds.
- Moyamoya disease – A condition that causes the arteries in the brain to narrow, which limits blood flow to the brain. This increases the risk for seizures, stroke, and cognitive problems.
Treatment varies depending on the type of blood vessel that is involved, the type of vascular malformation or condition, and the overall health of the patient. Not all patients with a vascular malformation need surgery, though it is common for those with an AVM or moyamoya disease.
Vertebral osteomyelitis (also called spondylodiscitis)
Vertebral osteomyelitis is a rare bone infection of the spine that affects the vertebrae. It can happen as the result of a spinal injury or after surgery. It can also spread to the spine in the bloodstream from another part of the body.
Some children have a higher risk of developing osteomyelitis, such as those with a weak immune system or chronic conditions like sickle cell disease. If a child has a fever and bone pain, visit the doctor right away. Osteomyelitis can get worse within hours or days and become much harder to treat.
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Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
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Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
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Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
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Brain and spinal cord tumors
A brain and spinal cord tumor, also known as a central nervous system (CNS) tumor, is an abnormal growth that occurs in any part of the brain or spinal cord. Tumors are either benign (non-cancerous) or malignant (cancerous). Benign tumors are slow growing, rarely spread, and usually can be completely removed. Malignant tumors are usually rapidly growing, invasive, and often life threatening.
Brachial plexus injuries
The brachial plexus is a network of nerves in the shoulder that carries movement and sensory signals from the spinal cord to the arms and hands. Injuries from trauma to the neck can cause pain, weakness, numbness and paralysis in the arm and hand. Some brachial plexus injuries heal on their own or with physical and occupational therapy, but more severe injuries require surgery to restore normal function.
Specialty neuroscience programs we offer at Children’s Minnesota
- Brain Injury & Concussion program
- Down Syndrome Clinic
- Epilepsy & Seizures Center
- Neuro-Oncology; Brain and Spinal Cord Tumor Program
- Neurology program
- Neurosurgery program
- Spina Bifida & Fetal Clinic
- Stroke & Cerebrovascular Center
