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Children's Medical Services - Special services for children with special needs
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Infant Toddler Development Training
Module 6, Lesson 4

Spinal Cord Problems

There are neurological conditions that directly affect the spinal cord. These include Syrinx, Disc Disease, and Transverse Myelitis.

A syrinx is associated with an Arnold-Chiari malformation in 90% of the cases. A syrinx is a fluid-filled cavity that develops in the spinal cord. It is sometimes called a syringomyelia. Thirty percent of tumors in the spine result in a syrinx. They create pressures on the cord and reduce or eliminate the sensation of pain and changes in temperature. Most commonly a syrinx occurs in the neck area, however they may also extend into the brain. This requires draining the defect and it can reoccur and need to be re-drained. Magnetic resonance imaging (MRI) is used to diagnose and follow the condition. The ITDS can assist the family to carefully check water and food temperatures and also alert the family to take particular precautions around fire for children with this condition.

Disc disease (literally, a wearing away of a disc pad between the spinal bones) is compression of a disc with resulting pressure on nerves and tissue. It may be associated with one of the orthopedic conditions, but also can damage nerves. It is unusual in children unless present from birth.

Transverse myelitis is an inflammatory process involving the spinal cord's gray and white matter that may be associated with spina bifida and other neurological disorders.

Tumors

Tumors are uncontrolled cellular growth that creates abnormal masses. There are two types: Primary and Secondary. A primary tumor is located in the organ where the overgrowth of cellular tissue originated. A secondary tumor is made of cells that originated in another organ and spread (metastasized) to other locations. Most brain tumors in childhood are primary tumors that originate in nerve cells of the brain called glia cells.

grandfather holding little girlAnother way to consider tumors is that some are benign and some are malignant. A benign tumor grows slowly and doesn't spread to other locations. A malignant tumor spreads quickly to other areas of the body. Malignant tumors are referred to as cancer.

Clinical Signs

Some of the symptoms of brain tumors in early childhood include nausea and vomiting, headaches, changes in growth, cognition, and irritability. A brain tumor may cause other issues such as diabetes or changes in metabolism.

Diagnostic methods of confirming a brain tumor include an electroencephalogram (EEG), a computerized tomography (CT) scan, or MRI scan. After the diagnosis is made, treatment options include radiation therapy to shrink the tumor and chemotherapy. Daily care of the child undergoing treatment includes control of the nausea and vomiting and reassurance about the loss of weight and of hair.

There may be a need for short term occupational, physical, or speech therapy as treatment will destroy some of the normal brain cells. Effects of the tumor and/or of the treatment may be short or long term learning disabilities. A neurologist and/or oncologist usually follow the child to ensure that there is not a recurrence of the tumor. The primary role of the ITDS will be supporting the family in locating information and other community resources.

Peripheral Nerve Problems

There are several neurological conditions related to peripheral nerve problems that may be manifest in infants and toddlers. Most of these conditions are rare and affect many peripheral nerves. Some, however, affect isolated nerves such as a facial nerve palsy or an Erb's palsy affecting an arm and are frequently due to birth trauma.

 

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