Friday, October 31, 2014

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.
Read more here

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.”
Read more here

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  reported nationally for  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  frequently co-occur with other behavioral problems, with evidence that inadequate sleep is associated with daytime sleepiness, less optimal adjustment, and problems of irritability, hyperactivity and attention."
Boekamp's team was interested in learning more about sleep and  in  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 , 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."
Read more here

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."
Read more here

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.
Read more here

Thursday, October 30, 2014

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.



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.


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.


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).


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.

Monday, October 27, 2014

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.

Saturday, October 25, 2014

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.

Absence of the Septum Pellucidum
Acid Lipase Disease 
Acid Maltase Deficiency
Acquired Epileptiform Aphasia
Acute Disseminated Encephalomyelitis

Adie's Pupil
Adie's Syndrome
Agenesis of the Corpus Callosum

Aicardi Syndrome
Aicardi-Goutieres Syndrome Disorder

Alexander Disease

Alpers' Disease

Alternating Hemiplegia


Angelman Syndrome
Antiphospholipid Syndrome

Arachnoid Cysts
Arnold-Chiari Malformation

Arteriovenous Malformation
Asperger Syndrome
Ataxia Telangiectasia
Ataxias and Cerebellar or Spinocerebellar Degeneration

Attention Deficit-Hyperactivity Disorder
Autonomic Dysfunction

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

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

Canavan Disease
Carpal Tunnel Syndrome

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
Chronic Inflammatory Demyelinating Polyneuropathy (CIDP)

Chronic Orthostatic Intolerance
Chronic Pain
Cockayne Syndrome Type II
Coffin Lowry Syndrome

Complex Regional Pain Syndrome
Congenital Facial Diplegia
Congenital Myasthenia
Congenital Myopathy

Congenital Vascular Cavernous Malformations
Corticobasal Degeneration
Cranial Arteritis
Cree encephalitis

Creutzfeldt-Jakob Disease
Cumulative Trauma Disorders
Cushing's Syndrome
Cytomegalic Inclusion Body Disease
Cytomegalovirus Infection


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 - Multi-Infarct
Dementia - Semantic
Dementia - Subcortical

Dementia With Lewy Bodies
Dentate Cerebellar Ataxia
Dentatorubral Atrophy
Developmental Dyspraxia

Devic's Syndrome
Diabetic Neuropathy
Diffuse Sclerosis
Dravet Syndrome

Dyssynergia Cerebellaris Myoclonica

Dyssynergia Cerebellaris Progressiva

Early Infantile Epileptic Encephalopathy
Empty Sella Syndrome
Encephalitis Lethargica

Encephalopathy (familial infantile)
Encephalotrigeminal Angiomatosis
Epileptic Hemiplegia

Erb-Duchenne and Dejerine-Klumpke Palsies
Erb's Palsy
Essential Tremor
Extrapontine Myelinolysis


Fabry Disease
Fahr's Syndrome
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 

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


Hallervorden-Spatz Disease
Head Injury
Hemicrania Continua
Hemifacial Spasm

Hemiplegia Alterans
Hereditary Neuropathies
Hereditary Spastic Paraplegia
Heredopathia Atactica Polyneuritiformis
Herpes Zoster

Herpes Zoster Oticus
Hirayama Syndrome
Holmes-Adie syndrome 
HTLV-1 Associated Myelopathy

Hughes Syndrome
Huntington's Disease
Hydrocephalus - Normal Pressure




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

Intestinal Lipodystrophy
Intracranial Cysts
Intracranial Hypertension
Isaacs' Syndrome

Joubert Syndrome


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



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
Levine-Critchley Syndrome

Lewy Body Dementia
Lipid Storage Diseases
Lipoid Proteinosis
Locked-In Syndrome

Lou Gehrig's Disease
Lupus - Neurological Sequelae
Lyme Disease - Neurological Complications


Machado-Joseph Disease
Melkersson-Rosenthal Syndrome

Meningitis and Encephalitis
Menkes Disease
Meralgia Paresthetica
Metachromatic Leukodystrophy

Miller Fisher Syndrome
Mini Stroke
Mitochondrial Myopathies
Moebius Syndrome

Monomelic Amyotrophy
Motor Neuron Diseases
Moyamoya Disease

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

Myopathy - Congenital
Myopathy - Thyrotoxic

Myotonia Congenita


Neurodegeneration with Brain Iron Accumulation
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 
Neuronal Ceroid Lipofuscinosis
Neuronal Migration Disorders
Neuropathy - Hereditary

Nevus Cavernosus
Niemann-Pick Disease

Normal Pressure Hydrocephalus


Occipital Neuralgia
Ohtahara Syndrome
Olivopontocerebellar Atrophy
Opsoclonus Myoclonus
Orthostatic Hypotension

O'Sullivan-McLeod Syndrome
Overuse Syndrome


Pain - Chronic
Pantothenate Kinase-Associated Neurodegeneration
Paraneoplastic Syndromes
Parkinson's Disease

Paroxysmal Choreoathetosis
Paroxysmal Hemicrania
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
Pompe Disease
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

Pseudo-Torch syndrome
Pseudotoxoplasmosis syndrome
Pseudotumor Cerebri
Psychogenic Movement


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


Sacral Nerve Root Cysts
Saint Vitus Dance
Salivary Gland Disease
Sandhoff Disease
Schilder's Disease

Seitelberger Disease
Seizure Disorder
Semantic Dementia
Septo-Optic Dysplasia

Severe Myoclonic Epilepsy of Infancy (SMEI)
Shaken Baby Syndrome
Shy-Drager Syndrome
Sjögren's Syndrome

Sleep Apnea
Sleeping Sickness
Sotos Syndrome
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

Sturge-Weber Syndrome
Subacute Sclerosing Panencephalitis
Subcortical Arteriosclerotic Encephalopathy
SUNCT Headache
Swallowing Disorders

Sydenham Chorea
Syphilitic Spinal Sclerosis

Systemic Lupus Erythematosus


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
Trigeminal Neuralgia
Tropical Spastic Paraparesis
Troyer Syndrome

Tuberous Sclerosis


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

WWallenberg's Syndrome
Werdnig-Hoffman Disease
Wernicke-Korsakoff Syndrome
West Syndrome

Williams Syndrome
Wilson Disease
Wolman’s Disease 


X-Linked Spinal and Bulbar Muscular Atrophy

Zellweger Syndrome