ADHD and Fatty Acids

A study shows that omega 3 and 6 supplements can help children who have ADHD.

Supplements of the fatty acids omega 3 and 6 can help children and adolescents who have a certain kind of ADHD. These are the findings of a dissertation at the Sahlgrenska Academy, University of Gothenburg, which also indicates that a special cognitive training program can improve problem behavior in children with ADHD.

Between three to six percent of all school age children are estimated to have ADHD (Attention Deficit Hyperactivity Disorder). ADHD is a disorder that entails a difficulty controlling impulses and temper, sitting still, waiting, or being attentive for more than short periods at a time. There are various kinds of ADHD where disturbances in attention, hyperactivity and impulsivity have varying degrees of prominence.

ADHD is often treated with stimulant medications, which are effective for most, but do not work for everyone.

Relevant improvement

In this study, 75 children and adolescents with ADHD were given either the fatty acids omega 3 and 6 or a placebo over three months, and then they were all given omega 3/6 over three months. The study was conducted double-blind, which means that neither the researchers nor the participants were allowed to know whether they received the active capsules until afterwards.

"For the group as a whole, we did not see any major improvement, but in 35 percent of the children and adolescents who have the inattentive subtype of ADHD called ADD, the symptoms improved so much that we can talk about a clinically relevant improvement," says Mats Johnson, doctoral student at the Sahlgrenska Academy at the University of Gothenburg.

Cognitive training

The levels of omega 3 and omega 6 were also measured in blood samples, where those who had a clear improvement of their symptoms also showed a better balance between the blood levels of these two fatty acids.

The dissertation also indicates that a cognitive training method called Collaborative Problem Solving (CPS) can be a good alternative or complement in the treatment of ADHD and oppositional defiant disorder (ODD).

Solving problematic situations

With this method the children and the family receives help in training cognitive ability and solving problematic situations. The study included 17 children, whose families received up to ten weeks of CPS sessions. The families were then asked how much the behavioral problems improved directly after the treatment as well as six months afterwards.

"Our study of CPS as a treatment for ADHD and ODD is the first in Sweden. All families in our study completed the treatment, and half of them experienced a large or very large improvement of the behavioral problems," says Mats Johnson.

Combination treatment

The patient group that still had severe ADHD symptoms when the CPS treatment was complete were given the opportunity to supplement treatment with stimulants medication. In the follow-up six months later, 81 percent of all of the participating families experienced a large or very large improvement.

According to Mats Johnson, this indicates that CPS can improve problem-creating behavior in children ADHD and ODD, and that children with severe ADHD symptoms can be improved with a combination of CPS and ADHD medication.

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Your sinusitis may be a migraine

This article explains that many sinusitis diagnoses may actually be misdiagnosed migraine headaches.

Many people with migraine headaches are first misdiagnosed with, and treated for, sinusitis problems leading to an impaired quality of life, according to migraine expert and surgeon Elliot Shevel from the Headache Clinic, a group of private treatment facilities across the country.

New research has been published in recent years confirming the trend, said Shevel, and showing “the importance of clinicians making a proper and correct diagnosis”.

Painful effects
According to United States-based medical research organisation Mayo Clinic, migraines are chronic headaches commonly accompanied by symptoms such as nausea and sensitivity to light and sound. They are caused by the “activation of a mechanism deep in the brain that leads to the release of pain-producing inflammatory substances around the nerves and blood vessels of the head”, according to the World Health Organisation’s website. 

Sinusitis is inflammation of the cavities around the nasal passages and can be caused by having a cold, allergies and bacterial or fungal infections, according to Mayo Clinic. 

In a 2013 study published in the Journal of Headache and Pain, 130 migraine patients in Kuwait were asked about their headache history. More than 80% had been initially misdiagnosed as having sinusitis, with the correct migraine diagnosis taking anywhere from one to 38 years of seeking treatment.

Most of the 80% of patients who had been misdiagnosed previously were treated with medication, but 12% underwent surgery to help alleviate sinusitis.

The reason for the high rate of misdiagnosis, according to the researchers, is that “symptoms suggestive of sinusitis are frequently seen in migraine patients”, including congestion in the nasal passageways prompting them to call for general practitioners to be more aware of the diagnostic criteria for migraine.  

Medication overuse
An inaccurate migraine diagnosis can lead to further problems such as medication overuse headaches, said Headache Clinic managing director Daniel Shevel.

Medication overuse headaches occur when chronic use of painkillers begins to cause head pain. Migraine sufferers who receive little relief from sinusitis medication may begin to self-medicate in this way, according to Shevel. 

“Sufferers are between a rock and a hard place – if they resist the pain medication they suffer the pain, but if they take it they make future pain more likely.”

Migraines can be debilitating and some last for up to 72 hours, but there are effective treatments available, said Shevel. “The first step, however, is being accurately diagnosed.”

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Study: Sleep issues common for children with psychiatric disorders

A study found that sleep issues are more common for children with a psychiatric disorder.

John Boekamp, Ph.D., clinical director of the Pediatric Partial Hospital Program (PPHP) at Bradley Hospital recently led a study that found sleep difficulties - particularly problems with falling asleep - were very common among toddlers and preschool-aged children who were receiving clinical treatment for a wide range of psychiatric disorders. The study, titled "Sleep Onset and Night Waking Insomnias in Preschoolers with Psychiatric Disorders," is now published online in the journal Child Psychiatry & Human Development.

"The most common sleep difficulties reported nationally for toddlers and preschoolers are problems of going to bed, falling asleep and frequent night awakenings – collectively, these problems are referred to as behavioral insomnias of childhood," said Boekamp. "Sleep problems in young children frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal preschooladjustment, and problems of irritability, hyperactivity and attention."

Boekamp's team was interested in learning more about sleep and sleep problems in young children with behavior problems, as early sleep problems may be both a cause and consequence of children's difficulties with behavioral and emotional self-regulation. "Essentially, these young children might be caught in a cycle, with sleep disruption affecting their psychiatric symptoms and psychiatric symptoms affecting their sleep-wake organization," said Boekamp.

The partial program that Boekamp leads at Bradley Hospital is a family-centered, intensive day treatment program for very young children aged from newborn to six who have serious emotional, behavioral or relationship disturbances. This study examined the nature and prevalence of diagnostically defined sleep disorders, including Sleep Onset Insomnia (SOI) and Night Waking Insomnia (NWI), in a group of 183 young children admitted to the program. Diagnosable sleep disorders, particularly SOI, were quite common in the group, exceeding previous estimates obtained in community settings. Overall, 41 percent of children in the study also met diagnostic criteria for a sleep disorder. Sleep problems were especially common in children with disruptive behavior, attention, anxiety and mood problems.

"It is important for families to be aware of how important sleep is to the behavioral adjustment and wellbeing of young children," said Boekamp. "Sleep disorders may be unrecognized and under-diagnosed in young children, particularly when other behavioral or emotional problems are present."

Difficulties with sleep may be particularly important to address when children are also struggling with challenging daytime behaviors, such as problems with compliance, aggression, attention and mood. Sleepiness and fatigue may exacerbate these problem behaviors.

"This study is a great reminder that it's critical for mental health providers working with young children and their families to ask about children's sleep," said Boekamp. "Simple questions about children's sleep patterns, including how long it takes a child to fall asleep at night and how frequently a child awakens after falling asleep, may yield important information that is relevant to clinical care, even when sleep problems are not the primary focus of treatment."

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Air toxics and autism

A study found that children with autism are more likely to have been exposed to air toxics while in utero.

Children with autism spectrum disorder (ASD) were more likely to have been exposed to higher levels of certain air toxics during their mothers' pregnancies and the first two years of life compared to children without the condition, according to the preliminary findings of a University of Pittsburgh Graduate School of Public Health investigation of children in southwestern Pennsylvania.

This research, funded by The Heinz Endowments, will be presented today at the American Association for Aerosol Research annual meeting in Orlando, Fla.

"Autism spectrum disorders are a major public health problem, and their prevalence has increased dramatically," said Evelyn Talbott, Dr.P.H., principal investigator of the analysis and professor of epidemiology at Pitt Public Health. "Despite its serious social impact, the causes of autism are poorly understood. Very few studies of autism have included environmental exposures while taking into account other personal and behavioral risk factors. Our analysis is an addition to the small but growing body of research that considers air toxics as one of the risk factors for ASD."

Dr. Talbott and her colleagues performed a population-based study of families with and without ASD living in six southwestern Pennsylvania counties. The researchers found links between increased levels of chromium and styrene and childhood autism spectrum disorder, a condition that affects one in 68 children.

"This study brings us a step closer toward understanding why autism affects so many families in the Pittsburgh region and nationwide -- and reinforces in sobering detail that air quality matters," said Grant Oliphant, president of The Heinz Endowments. "Our aspirations for truly becoming the most livable city cannot be realized if our children's health is threatened by dangerous levels of air toxics. Addressing this issue must remain one of our region's top priorities."

Autism spectrum disorders are a range of conditions characterized by social deficits and communication difficulties that typically become apparent early in childhood. Reported cases of ASD have risen nearly eight-fold in the last two decades. While previous studies have shown the increase to be partially due to changes in diagnostic practices and greater public awareness of autism, this does not fully explain the increased prevalence. Both genetic and environmental factors are believed to be partially responsible.

Dr. Talbott and her team interviewed 217 families of children with ASD and compared these findings with information from two separate sets of comparison families of children without ASD born during the same time period within the six-county area. The families lived in Allegheny, Armstrong, Beaver, Butler, Washington and Westmoreland counties, and the children were born between 2005 and 2009.

One of the strengths of the study was the ability to have "two types of controls, which provided a comparison of representative air toxics in neighborhoods of those children with and without ASD," said Dr. Talbott.

For each family, the team used the National Air Toxics Assessment (NATA) to estimate the exposure to 30 pollutants known to cause endocrine disruption or neurodevelopmental issues. NATA is the Environmental Protection Agency's (EPA) ongoing comprehensive evaluation of air toxics in the U.S., most recently conducted in 2005.

Based on the child's exposure to concentrations of air toxics during the mother's pregnancy and the first two years of life, the researchers noted that children who fell into higher exposure groups to styrene and chromium were at a 1.4- to two-fold greater risk of ASD, after accounting for the age of the mother, maternal cigarette smoking, race and education. Other NATA compounds associated with increased risk included cyanide, methylene chloride, methanol and arsenic. As these compounds often are found in combination with each other, further study is needed.

Styrene is used in the production of plastics and paints, but also is one of the products of combustion when burning gasoline in vehicles. Chromium is a heavy metal, and air pollution containing it typically is the result of industrial processes and the hardening of steel, but it also can come from power plants. Cyanide, methylene chloride, methanol and arsenic are all used in a number of industries or can be found in vehicle exhaust.

"Our results add to the growing body of evidence linking environmental exposures, such as air pollution, to ASD," said Dr. Talbott. "The next step will be confirming our findings with studies that measure the specific exposure to air pollutants at an individual level to verify these EPA-modeled estimates."

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Link between not getting enough sleep and ulcerative colitis

A study shows that not getting enough sleep each night can increase a person's risk of developing ulcerative colitis.

If you are not getting the recommended seven-to-eight hours of sleep each night, you may be at increased risk of developing ulcerative colitis, according to a new study in Clinical Gastroenterology and Hepatology, the official clinical practice journal of the American Gastroenterological Association.

"Both short and long durations of sleep have important health implications and are associated with increased overall mortality, cardiovascular disease and cancer," said lead study author Ashwin N. Ananthakrishnan, MD, MPH, Massachusetts General Hospital. "Our findings indicate that ulcerative colitis may potentially be added to this list. We found that less than six hours of sleep per day and more than nine hours of sleep per day are each associated with an increased risk of ulcerative colitis."

Researchers conducted a prospective study of women who were enrolled in the Nurses' Health Study (NHS) I since 1976 and NHS II since 1989 and followed through detailed biennial questionnaires with greater than 90 percent follow-up. The large size of the cohorts, prospective design and prolonged duration of follow-up provide a unique opportunity to examine the association between sleep duration and incident disease with sufficient power to adjust for potential confounders.

The results demonstrated that there is a "U-shaped" relationship between sleep duration and risk of ulcerative colitis, with both short and long duration of sleep being associated with an increased risk of disease. These observed associations were independent of other known environmental risk factors.

In a previous study, also published in Clinical Gastroenterology and Hepatology last year, Ananthakrishnan and colleagues had reported that poor sleep quality, even while in remission, resulted in a two fold increase in risk of Crohn's disease flares at six months. "All these data together support a growing recognition of the impact of sleep disruption on the immune system, and the need for providers to frequently inquire about sleep duration and quality as an important parameter of health in patients with inflammatory bowel diseases," said Dr. Ananthakrishnan.

The authors acknowledge several study limitations. First, the study population consisted predominantly of white female nurses and is thus not representative of the gender and ethnic distribution in the general population. Sleep duration was also self-reported. However, the size of the study and quality of data substantiate these findings.

Future studies are warranted to better understand mechanisms by which sleep may influence intestinal inflammation.

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Whole Exome Sequencing in Pediatric Neurology Practice

Time to revisit your pediatric neurologist!

I have used this increasingly in my practice for autism, ataxia developmental delays and other undiagnosed disorders. 

It can make a therapeutic difference. - JR Houston, TX

Clinical whole exome sequencing in child neurology practice.

Srivastava S1, Cohen JS, Vernon H, Barañano K, McClellan R, Jamal L, Naidu S, Fatemi A.

Author information

Abstract

OBJECTIVE:

Whole exome sequencing (WES) represents a significant breakthrough in clinical genetics as a powerful tool for etiological discovery in neurodevelopmental disorders. To better characterize the genetic landscape of neurodevelopmental disorders, we analyzed patients in our pediatric neurogenetics clinic who underwent WES.

METHODS:

We performed a retrospective cohort study on 78 patients with various neurodevelopmental disabilities and unrevealing workup prior to WES. We characterized their molecular diagnoses, clinical features, and whether their previous treatment plan changed due to WES results.

RESULTS:

The overall presumptive diagnostic rate for our cohort was 41% (n = 32 of 78 patients). Nineteen patients had a single autosomal dominant (AD) disorder, 11 had a single autosomal recessive (AR) disorder, 1 had an X-linked dominant disorder, and 1 had both an AD and an AR disorder. The 32 patients with pathogenic or likely pathogenic variants exhibited various neurobehavioral and neuroimaging abnormalities, including intellectual disability/developmental delay (n = 28), cerebral palsy-like encephalopathy (n = 11), autism spectrum disorder (n = 5), delayed/hypomyelination (n = 7), and cerebellar abnormalities (n = 9). The results of WES affected management for all patients with a presumptive diagnosis, triggering reproductive planning (n = 27), disease monitoring initiation (n = 4), investigation of systemic involvement of the disorder(s) (n = 6), alteration of presumed disease inheritance pattern (n = 7), changing of prognosis (n = 10), medication discontinuation (n = 5) or initiation (n = 2), and clinical trial education (n = 3).

INTERPRETATION:

The high diagnostic yield of WES supports its use in pediatric neurology practices. It may also lead to earlier diagnosis, impacting medical management, prognostication, and family planning. WES therefore serves as a critical tool for the child neurologist. Ann Neurol 2014;76:473-483.

Tricare & Autism - New Access Rules and 46 percent reduction in ABA reimbursement!

Do you or your family member have Tricare for autism related services? 

Note MAJOR changes in the programs

"Those who are diagnosed with autism spectrum disorder after July 25 will receive current benefits under the Autism Care Demo by Dec. 31. Beneficiaries should contact their regional or plan contractor for information about how to get started."

Please let your legislator and the assistant sec-def named below know how important these services are. Many other insurances are playing this game. This cut is likely to affect access. - JR

TRICARE "Delays" Change in Autism Reimbursement to April

By Cheryl Pellerin
DoD News, Defense Media Activity

WASHINGTON, Oct. 10, 2014 – TRICARE has delayed until April a 46-percent reduction in the reimbursement level for some autism services while it awaits the results of an independent assessment of the prevailing rate for the services, defense officials said today.

The reduced reimbursement rate -- for one-on-one therapy with a board-certified behavior analyst for those with autism spectrum disorder -- was one of several program changes scheduled to go into effect Oct. 20 as TRICARE implements its new Comprehensive Autism Care Demonstration, or Autism Care Demo.

On Sept. 19, after the Defense Department published related changes to the TRICARE Operations Manual, providers and beneficiaries raised issues.

Rand Corp. independent analysis

On Oct. 8, Assistant Secretary of Defense for Health Affairs Dr. Jonathan Woodson directed that the rate change be postponed until April 20, 2015, while RAND Corp. completes an independent analysis of prevailing rates for the service.

TRICARE will continue to pay the previous rate of $125 an hour for one-on-one therapy with a board-certified behavior analyst rather than the new $68-per-hour rate. Defense officials say the new Autism Care Demo does not cut applied behavior analysis benefits.

The new TRICARE Autism Care Demo began July 25 and replaces current applied behavior analysis benefits with one simple program, according to the TRICARE website.

TRICARE-covered services

TRICARE covers the following services under the basic applied behavior analysis benefit, and a TRICARE-authorized board-certified behavior analyst must provide the services:

-- An initial applied behavior analysis assessment and treatment plan;

-- Direct one-on-one applied behavior analysis services;

-- Supervision of subordinate applied behavior analysis providers;

-- An updated applied behavior analysis treatment plan and updates; and

-- Training of family members or caregivers.

Study: Autistic children more sedentary than other children

A new study claims that autistic children are more sedentary than children without autism. JR

A new Oregon State University study of children with autism found that they are more sedentary than their typically-developing peers, averaging 50 minutes less a day of moderate physical activity and 70 minutes more each day sitting.

The small study of 29 children, some with autism and some without, showed that children with autism perform as well as their typical peers on fitness assessments such as body mass index, aerobic fitness levels and flexibility. The results warrant expanding the study to a larger group of children, said Megan MacDonald, an assistant professor in OSU's College of Public Health and Human Sciences.

"These kids, compared to their peers, are similarly fit," MacDonald said. "That's really exciting, because it means those underlying fitness abilities are there."

The findings were published this month in the journal Autism Research and Treatment. Co-authors are Kiley Tyler, a doctoral student at OSU, and Kristi Menear of the University of Alabama at Birmingham. The study was funded in part by the U.S. Department of Education with additional support from OSU.

For the study, researchers tested the fitness and physical activity levels of 17 children with autism and 12 children without autism. The fitness assessments, conducted in the Movement Studies in Disability Lab at OSU, included a 20-meter, multi-stage shuttle run to measure aerobic fitness; a sit-and-reach test to measure flexibility and a strength test to measure handgrip strength; as well as height, weight and body mass index measurements.

The fitness tests were selected in part because they are commonly used in schools, MacDonald said. Children in the study also wore accelerometers for a week to measure their movement, and parents filled out supplemental forms to report other important information.

Even though they were more sedentary, the children with autism lagged behind their peers on only one fitness measure, the strength test. The results were surprising but also encouraging because they show that children with autism are essentially on par with their peers when it comes to physical fitness activities, MacDonald said.

"That's really important for parents and teachers to understand, because it opens the door for them to participate in so many activities," she said.

More research is needed to determine why children with autism tend to be more sedentary, MacDonald said. It may be that children with autism have fewer opportunities to participate in organized sports or physical education activities, but if that is the case, it needs to change, she said.

"They can do it. Those abilities are there," she said. "We need to work with them to give them opportunities."

MacDonald encourages parents to make physical activity such as a daily walk or trip to the park part of the family's routine. She's also an advocate for adaptive physical education programs, which are school-based programs designed around a child's abilities and needs. Some communities also offer physical fitness programs such as soccer clubs that are inclusive for children with autism or other disabilities, she said.

"Physical fitness and physical activity are so important for living a healthy life, and we learn those behaviors as children," MacDonald said. "Anything we can do to help encourage children with autism to be more active is beneficial."

Read more here

Great Glossary of Neurology terms from the NINDS

Friends...Here is a useful glossary of terms relevant to pediatric neurology. I have abstracted some for educational purposes.

The full list is at the NIH's website at the NINDS.

A	Absence of the Septum Pellucidum Acid Lipase Disease  Acid Maltase Deficiency Acquired Epileptiform Aphasia Acute Disseminated Encephalomyelitis ADHD Adie's Pupil Adie's Syndrome Adrenoleukodystrophy Agenesis of the Corpus Callosum Agnosia Aicardi Syndrome Aicardi-Goutieres Syndrome Disorder Alexander Disease Alpers' Disease Alternating Hemiplegia Anencephaly Aneurysm Angelman Syndrome Angiomatosis Anoxia Antiphospholipid Syndrome Aphasia Apraxia Arachnoid Cysts Arachnoiditis Arnold-Chiari Malformation Arteriovenous Malformation Asperger Syndrome Ataxia Ataxia Telangiectasia Ataxias and Cerebellar or Spinocerebellar Degeneration Attention Deficit-Hyperactivity Disorder Autism Autonomic Dysfunction
B	Back Pain Barth Syndrome Batten Disease Becker's Myotonia Behcet's Disease Bell's Palsy Benign Essential Blepharospasm Benign Focal Amyotrophy Benign Intracranial Hypertension Bernhardt-Roth Syndrome Blepharospasm Bloch-Sulzberger Syndrome Brachial Plexus Birth Injuries Brachial Plexus Injuries Bradbury-Eggleston Syndrome Brain and Spinal Tumors Brain Aneurysm Brain Injury Brown-Sequard Syndrome Bulbospinal Muscular Atrophy
C	CADASIL Canavan Disease Carpal Tunnel Syndrome Causalgia Cavernomas Cavernous Angioma Cavernous Malformation Central Cervical Cord Syndrome Central Cord Syndrome Central Pain Syndrome Central Pontine Myelinolysis Cephalic Disorders Ceramidase Deficiency Cerebellar Degeneration Cerebellar Hypoplasia Cerebral Aneurysms Cerebral Arteriosclerosis Cerebral Atrophy Cerebral Beriberi Cerebral Cavernous Malformation Cerebral Gigantism Cerebral Hypoxia Cerebral Palsy Cerebro-Oculo-Facio-Skeletal Syndrome (COFS) Charcot-Marie-Tooth Disease Chiari Malformation Cholesterol Ester Storage Disease Chorea Choreoacanthocytosis Chronic Inflammatory Demyelinating Polyneuropathy (CIDP) Chronic Orthostatic Intolerance Chronic Pain Cockayne Syndrome Type II Coffin Lowry Syndrome Colpocephaly Coma Complex Regional Pain Syndrome Congenital Facial Diplegia Congenital Myasthenia Congenital Myopathy Congenital Vascular Cavernous Malformations Corticobasal Degeneration Cranial Arteritis Craniosynostosis Cree encephalitis Creutzfeldt-Jakob Disease Cumulative Trauma Disorders Cushing's Syndrome Cytomegalic Inclusion Body Disease Cytomegalovirus Infection
D	Dancing Eyes-Dancing Feet Syndrome Dandy-Walker Syndrome Dawson Disease De Morsier's Syndrome Deep Brain Stimulation for Parkinson's Disease Dejerine-Klumpke Palsy Dementia Dementia - Multi-Infarct Dementia - Semantic Dementia - Subcortical Dementia With Lewy Bodies Dentate Cerebellar Ataxia Dentatorubral Atrophy Dermatomyositis Developmental Dyspraxia Devic's Syndrome Diabetic Neuropathy Diffuse Sclerosis Dravet Syndrome Dysautonomia Dysgraphia Dyslexia Dysphagia Dyspraxia Dyssynergia Cerebellaris Myoclonica Dyssynergia Cerebellaris Progressiva Dystonias
E	Early Infantile Epileptic Encephalopathy Empty Sella Syndrome Encephalitis Encephalitis Lethargica Encephaloceles Encephalopathy Encephalopathy (familial infantile) Encephalotrigeminal Angiomatosis Epilepsy Epileptic Hemiplegia Erb-Duchenne and Dejerine-Klumpke Palsies Erb's Palsy Essential Tremor Extrapontine Myelinolysis
F	Fabry Disease Fahr's Syndrome Fainting Familial Dysautonomia Familial Hemangioma Familial Idiopathic Basal Ganglia Calcification Familial Periodic Paralyses Familial Spastic Paralysis Farber's Disease Febrile Seizures Fibromuscular Dysplasia Fisher Syndrome Floppy Infant Syndrome Foot Drop Friedreich's Ataxia Frontotemporal Dementia
S
G	Gaucher Disease Generalized Gangliosidoses Gerstmann's Syndrome Gerstmann-Straussler-Scheinker Disease Giant Axonal Neuropathy Giant Cell Arteritis Giant Cell Inclusion Disease Globoid Cell Leukodystrophy Glossopharyngeal Neuralgia Glycogen Storage Disease Guillain-Barré Syndrome
H	Hallervorden-Spatz Disease Head Injury Headache Hemicrania Continua Hemifacial Spasm Hemiplegia Alterans Hereditary Neuropathies Hereditary Spastic Paraplegia Heredopathia Atactica Polyneuritiformis Herpes Zoster Herpes Zoster Oticus Hirayama Syndrome Holmes-Adie syndrome  Holoprosencephaly HTLV-1 Associated Myelopathy Hughes Syndrome Huntington's Disease Hydranencephaly Hydrocephalus Hydrocephalus - Normal Pressure Hydromyelia Hypercortisolism Hypersomnia Hypertonia Hypotonia Hypoxia
I	Immune-Mediated Encephalomyelitis Inclusion Body Myositis Incontinentia Pigmenti Infantile Hypotonia Infantile Neuroaxonal Dystrophy  Infantile Phytanic Acid Storage Disease Infantile Refsum Disease Infantile Spasms Inflammatory Myopathies Iniencephaly Intestinal Lipodystrophy Intracranial Cysts Intracranial Hypertension Isaacs' Syndrome
J	Joubert Syndrome
K	Kearns-Sayre Syndrome Kennedy's Disease Kinsbourne syndrome Kleine-Levin Syndrome Klippel-Feil Syndrome Klippel-Trenaunay Syndrome (KTS) Klüver-Bucy Syndrome Korsakoff's Amnesic Syndrome Krabbe Disease Kugelberg-Welander Disease Kuru
L	Lambert-Eaton Myasthenic Syndrome Landau-Kleffner Syndrome Lateral Femoral Cutaneous Nerve Entrapment Lateral Medullary Syndrome Learning Disabilities Leigh's Disease Lennox-Gastaut Syndrome Lesch-Nyhan Syndrome Leukodystrophy Levine-Critchley Syndrome Lewy Body Dementia Lipid Storage Diseases Lipoid Proteinosis Lissencephaly Locked-In Syndrome Lou Gehrig's Disease Lupus - Neurological Sequelae Lyme Disease - Neurological Complications
M	Machado-Joseph Disease Macrencephaly Megalencephaly Melkersson-Rosenthal Syndrome Meningitis Meningitis and Encephalitis Menkes Disease Meralgia Paresthetica Metachromatic Leukodystrophy Microcephaly Migraine Miller Fisher Syndrome Mini Stroke Mitochondrial Myopathies Moebius Syndrome Monomelic Amyotrophy Motor Neuron Diseases Moyamoya Disease Mucolipidoses Mucopolysaccharidoses Multifocal Motor Neuropathy Multi-Infarct Dementia Multiple Sclerosis Multiple System Atrophy Multiple System Atrophy with Orthostatic Hypotension Muscular Dystrophy Myasthenia - Congenital Myasthenia Gravis Myelinoclastic Diffuse Sclerosis Myoclonic Encephalopathy of Infants Myoclonus Myopathy Myopathy - Congenital Myopathy - Thyrotoxic Myotonia Myotonia Congenita
N	Narcolepsy Neuroacanthocytosis Neurodegeneration with Brain Iron Accumulation Neurofibromatosis Neuroleptic Malignant Syndrome Neurological Complications of AIDS Neurological Complications of Lyme Disease Neurological Consequences of Cytomegalovirus Infection Neurological Manifestations of Pompe Disease Neurological Sequelae Of Lupus Neuromyelitis Optica  Neuromyotonia Neuronal Ceroid Lipofuscinosis Neuronal Migration Disorders Neuropathy - Hereditary Neurosarcoidosis Neurosyphilis Neurotoxicity Nevus Cavernosus Niemann-Pick Disease Normal Pressure Hydrocephalus
O	Occipital Neuralgia Ohtahara Syndrome Olivopontocerebellar Atrophy Opsoclonus Myoclonus Orthostatic Hypotension O'Sullivan-McLeod Syndrome Overuse Syndrome
P	Pain - Chronic Pantothenate Kinase-Associated Neurodegeneration Paraneoplastic Syndromes Paresthesia Parkinson's Disease Paroxysmal Choreoathetosis Paroxysmal Hemicrania Parry-Romberg Pelizaeus-Merzbacher Disease Pena Shokeir II Syndrome Perineural Cysts Periodic Paralyses Peripheral Neuropathy Periventricular Leukomalacia Persistent Vegetative State Pervasive Developmental Disorders Phytanic Acid Storage Disease Pick's Disease Pinched Nerve Piriformis Syndrome Pituitary Tumors Polymyositis Pompe Disease Porencephaly Postherpetic Neuralgia Postinfectious Encephalomyelitis Post-Polio Syndrome Postural Hypotension Postural Orthostatic Tachycardia Syndrome Postural Tachycardia Syndrome Primary Dentatum Atrophy Primary Lateral Sclerosis Primary Progressive Aphasia Prion Diseases Progressive Hemifacial Atrophy Progressive Locomotor Ataxia Progressive Multifocal Leukoencephalopathy Progressive Sclerosing Poliodystrophy Progressive Supranuclear Palsy Prosopagnosia Pseudo-Torch syndrome Pseudotoxoplasmosis syndrome Pseudotumor Cerebri Psychogenic Movement
R	Ramsay Hunt Syndrome I  Ramsay Hunt Syndrome II Rasmussen's Encephalitis Reflex Sympathetic Dystrophy Syndrome Refsum Disease Refsum Disease - Infantile Repetitive Motion Disorders Repetitive Stress Injuries Restless Legs Syndrome Retrovirus-Associated Myelopathy Rett Syndrome Reye's Syndrome Rheumatic Encephalitis Riley-Day Syndrome
S	Sacral Nerve Root Cysts Saint Vitus Dance Salivary Gland Disease Sandhoff Disease Schilder's Disease Schizencephaly Seitelberger Disease Seizure Disorder Semantic Dementia Septo-Optic Dysplasia Severe Myoclonic Epilepsy of Infancy (SMEI) Shaken Baby Syndrome Shingles Shy-Drager Syndrome Sjögren's Syndrome Sleep Apnea Sleeping Sickness Sotos Syndrome Spasticity Spina Bifida Spinal Cord Infarction Spinal Cord Injury Spinal Cord Tumors Spinal Muscular Atrophy Spinocerebellar Atrophy Spinocerebellar Degeneration Steele-Richardson-Olszewski Syndrome Stiff-Person Syndrome Striatonigral Degeneration Stroke Sturge-Weber Syndrome Subacute Sclerosing Panencephalitis Subcortical Arteriosclerotic Encephalopathy SUNCT Headache Swallowing Disorders Sydenham Chorea Syncope Syphilitic Spinal Sclerosis Syringohydromyelia Syringomyelia Systemic Lupus Erythematosus
T	Tabes Dorsalis Tardive Dyskinesia Tarlov Cysts Tay-Sachs Disease Temporal Arteritis Tethered Spinal Cord Syndrome Thomsen's Myotonia Thoracic Outlet Syndrome Thyrotoxic Myopathy Tic Douloureux Todd's Paralysis Tourette Syndrome Transient Ischemic Attack Transmissible Spongiform Encephalopathies Transverse Myelitis Traumatic Brain Injury Tremor Trigeminal Neuralgia Tropical Spastic Paraparesis Troyer Syndrome Tuberous Sclerosis
V	Vascular Erectile Tumor Vasculitis Syndromes of the Central and Peripheral Nervous Systems  Von Economo’s Disease Von Hippel-Lindau Disease (VHL) Von Recklinghausen's Disease
W	Wallenberg's Syndrome Werdnig-Hoffman Disease Wernicke-Korsakoff Syndrome West Syndrome Whiplash Williams Syndrome Wilson Disease Wolman’s Disease
X	X-Linked Spinal and Bulbar Muscular Atrophy
Z	Zellweger Syndrome