» Services & Innovations
• DMC Children’s Hospital of Michigan is home to the world’s first pediatric-dedicated Positron Emission Tomography (PET) scanner.
• Home to Michigan’s top pediatric imaging center, the Children’s Hospital of Michigan is one of only a handful of children’s hospitals in the nation to have a 3.0 Tesla short bore scanner.
• Experts at the Children’s Hospital of Michigan use advanced technologies like the state-of-art 192 channel epilepsy monitoring system with video to precisely locate the origin of epileptic foci.
Services and Treatments offered through the Neurology Department at the Children's Hospital of Michigan
Attention Deficit Hyperactivity Disorder (ADHD)
Experts at the ADHD Clinic conduct extensive testing and may treat patients with one or more medications. Parents of children with ADHD may also benefit from behavior management skills and a support group.
Specialists on staff provides evaluation and multi-disciplinary treatment for children and support for families affected by autism. This includes meetings to evaluate patients, discussion of test results, diagnosis and treatment recommendations. Recommendations may include appropriate referrals to other pediatric subspecialists and support disciplines. Evaluations and/or treatment may include: early intensive behavioral intervention, gastroenterology, genetics, occupational, physical and/or speech therapies and social work. Children’s Hospital of Michigan physicians and therapists on staff also coordinate activities including multidisciplinary services with University Pediatricians Autism Center .The department participates in multi-site clinical research trials to develop evidence based standards for medical treatment of Autism Spectrum. At the Children’s Hospital of Michigan, National Institutes of Health funded research in autism identified some of the neuro-chemical pathways associated with autism using MRI and PET technology. Research includes a five-year, nationwide NIH funded study into drug therapy for this disorder. In addition, other funded pharmaceutical drug trials are ongoing to reduce autistic symptoms.
Advanced Neurodiagnostics and Imaging
Advanced imaging technology is vital for accurate diagnosis and precise treatment of pediatric neurological diseases. Children's Hospital's Imaging Department operates a PET center and two MRI scanners, including a 3.0 Tesla scanner. Electromyography (EMG) and Nerve Conduction Velocity (NCV) testing is also available.
The ultimate goal of brain surgery is to provide a cure without a patient experiencing functional deficits. The Hospital’s Neurodiagnostics Lab offers brain mapping tools that enable pediatric neurosurgeons to pinpoint or map the focus of seizure activity within the brain so that they may perform brain surgery on small patients with great precision. Neuropsychological testing is also used to help clarify the behavioral and cognitive issues related to a child’s epilepsy. The pediatric neuro-experts on staff have significant experience using surgical treatments for patients with infantile spasms, tuberous sclerosis complex and Sturge-Weber syndrome. Pediatric epileptologists and neurosurgeons on staff at the Children's Hospital of Michigan have significant experience treating patients with these conditions referred from within and outside the country. Children's Hospital of Michigan also offers a specialized brain-mapping software program. Where this technology once provided two- or three-dimensional images, it now offers four-dimensional brain mapping and image of the brain, animating neural activation every 0.01 seconds. This brain mapping technology allows the surgeon to visualize “where” and “when” functionally important brain structures work, and to more precisely localize the seizure focus.
Approximately, 90 percent of patients with seizure focus in functionally unimportant areas of the brain benefit from surgical removal of the seizure focus. About 80 percent of these patients become seizure free. For patients with seizure focus in a functionally important area, the pediatric neurological doctors on staff will discuss with the family and patient the pros and cons of conservative and aggressive treatment options, always considering the best interest of the patient and family. A variety of surgical treatment options are available based upon the patient's specific diagnosis.
A number of departments within the Children’s Hospital of Michigan treat behavioral and developmental problems. Doctors, nurses, dietitians, social workers and others can have a hand in assisting parents in managing developmental or behavioral issues in their children.
Electromyography (EMG)/Nerve Conduction Velocity (NCV)
Electromyography or EMG involves testing the electrical activity of muscles. An EMG is generally done in conjunction with a nerve conduction velocity test. The NCV measures the speed of conduction of an electrical impulse through a nerve. NCV can determine nerve damage and destruction.
At the Children’s Hospital of Michigan, neurologists specialize in diagnosing and treating children with epilepsy and related conditions such as Sturge-Weber syndrome. Treatment options generally include drug therapy. In some cases where drug therapy is unsuccessful, Children’s Hospital of Michigan uses alternative treatments such as the ketogenic diet and epilepsy surgery when appropriate. Using PET scanning, neurologists pinpoint the origin of epileptic seizures so that neurosurgeons can remove affected tissue in the brain. This procedure often improve the patient’s condition dramatically, with success rates in the 80- to 90-percent range. Physicians at the Children’s Hospital of Michigan are also involved in groundbreaking epilepsy research – including National Institutes of Health and National Institutes of Neurological Disorders and Stroke funded projects.
Using innovative therapies and medications, neurologists at the Children’s Hospital of Michigan can often provide substantial pain relief to patients. In rare cases when headache pain is a sign of a more serious problem, neurologists work with other specialists to ensure appropriate treatment.
The headache clinic addresses common conditions such as migraine and tension type headache as well as rarer diseases such as cluster, post traumatic headache, new daily persistent headache and autonomic cephalgias. In addition to providing up to date traditional treatment, staff encourage and guide interested families in the use of natural supplements, physical therapy, psychological intervention and referral to inpatient services as deemed appropriate.
The clinic sees more than 1000 headache related visits per year from throughout the state of Michigan. Neurologists work closely with dietitians, nurse practitioners, nurses and other specialties such as neuro-ophthalmologists to ensure the highest quality of care for patients.
Dietary treatment of medically uncontrolled seizures is another treatment option. In certain pediatric epilepsies like Doose syndrome or myoclonia-astatic epilepsy, it can be the first line treatment. The Children’s Hospital of Michigan Division of Pediatric Neurology offers a variety of dietary treatment options for pediatric epilepsy. Each diet type is carefully selected in consultation with the patient’s family and physician and instruction and monitoring is provided by the registered dietitian. The “Keto Team” at Children’s Hospital of Michign includes the Pediatric Neurologist, Nurse Practitioner, and Registered Dietitian.
The “classic” Ketogenic diet is a high-fat, low-carbohydrate diet that has been used to treat medically uncontrolled seizures for over 100 years. The team at the Children’s Hospital of Michigan has been using this diet to help children for about 20 years. The classic Ketogenic diet is the strictest version of the diet, requiring food to be weighed on a gram scale. The child is encouraged to eat all of the food provided at a meal or snack and nothing else. This diet is also the most researched, with hundred’s of scientific studies demonstrating seizure reduction. On average, 1/3 of patients see a >90% reduction in seizures, 1/3 see a 50-90% reduction, and 1/3 see <50%. The diet has been shown to be potentially effective with any types of seizure.
Other dietary treatment options available at Children’s Hospital of Michigan include: the Modified Atkins Diet (MAD), which monitors the amount of carbohydrates per day and encourages fat intake, and the Low Glycemic Index diet (LGI), which limits carbohydrates to those low in glycemic index foods.
If you think you are interested in a classic Ketogenic, MAD, or LGI diet for your child, please discuss this with your Neurologist and Nurse Practitioner. Next, schedule an appt with the Registered Dietitian to discuss your treatment options. If your child is started on a therapeutic diet, regular follow-up appointments will be made with the dietitian.
The Children’s Hospital of Michigan has the experts to treat leukodystrophy, a group of rare genetic disorders that affect the central nervous system. Some leukodystrophies (there are more than 30) can be treated with medications, physical, occupational and speech therapies, as well as nutritional, educational and recreational programs. A few leukodystrophies can be treated with bone marrow transplantation.
Multiple Sclerosis and Neuroimmunology Center
Multiple sclerosis is a chronic disease of the central nervous system. It is an unpredictable condition that can be relatively benign, disabling or devastating. Symptoms are the same in children as they are in adults, and often can be treated with physical therapy and medications to help control the symptoms. The Pediatric Multiple Sclerosis (MS) and Neuroimmunology Center at DMC Children's Hospital of Michigan is a comprehensive center that specializes in diagnosing and treating pediatric demyelinating and autoimmune disorders involving the brain and nervous system.
Neurofibromatosis, also known as (NF) is a genetic disorder of the nervous system that can affect many parts of the body, including the brain, spinal cord, nerves, skin, and other body systems. NF can cause growth of non-cancerous tumors on nerve tissue, producing skin and bone abnormalities. Some children live almost unaffected by it, others, can be severely disabled. Children’s Hospital of Michigan offers a Neurofibromatosis Clinic that provides comprehensive care including diagnosis, treatment and research.
Neurogenetic and Metabolic Disorders
Pediatric neurogenetic experts at the Children’s Hospital of Michigan offer comprehensive diagnostic and care services for children who have – or are suspected of having – a genetic disorder affecting the nervous system or muscles. A true leader in this field, Children’s Hospital of Michigan is home to the nation’s only generalized neurogenetic DNA bank, a research program that promises to unlock the secrets of many neurological diseases at the molecular level.
Neuromuscular Diseases and Muscular Dystrophy
The Neurology Department at the Children’s Hospital of Michigan is nationally known for research, diagnosis and treatment of pediatric neuromuscular diseases such as muscular dystrophy, Charcot-Marie-Tooth disease and spinal muscular atrophy. Patients at Children’s Hospital have access to innovative treatments and medications during clinical trials. Working in conjunction with the Muscular Dystrophy Association, the Department offers a multidisciplinary muscular dystrophy clinic.
Using advanced imaging technology, neurologists at the Children’s Hospital of Michigan are highly skilled in identifying the precise cause of pediatric stroke – a vital step in providing the right treatment and preventing more injury. Additionally, they are conducting research into pediatric stroke diagnosis, treatment and prevention.
Home to the state’s only sleep center exclusively for children, DMC Children’s Hospital of Michigan, has helped thousands of children improve their sleep. Pediatric sleep experts use the latest techniques and technologies to help infants, children and adolescents begin to benefit from appropriate sleep.
The Children’s Hospital of Michigan Sleep Center is comprised of sleep labs in the community and a sleep clinic for assessments and evaluations by pediatric specialists. When a child is referred to the Sleep Clinic, he or she will be evaluated by physicians at the Children’s Hospital of Michigan or an affiliated facility. For some disorders, the child will see a psychologist or other health care professionals.
The PET Center team at the Children’s Hospital of Michigan is using innovative imaging techniques to study Tourette Syndrome in children. The neurology team were the first in the world to use PET scanning to study serotonin in Tourette syndrome. Their research discovered that brain abnormalities in Tourette’s patients fall into four distinct patterns. Combined with genetic research, these patterns may help physicians treat the condition.
Tuberous Sclerosis Complex (TSC) Clinic
Tuberous sclerosis complex (TSC) is an autosomal dominant neurocutaneous disorder associated with the development of tumors in various organs of the body including the brain, skin, kidneys, heart and lungs. Neurologic involvement occurs in >90% of individuals with TSC and neurologic manifestations include seizures, cognitive impairment, autism and behavioral and psychiatric problems. Seizures may occur in up to 80% of children with TSC and, seizures can be medically uncontrolled in up to 60%.
Children's Hospital of Michigan is one of only a few TS alliance recognized clinics in the country and the only one in metro Detroit. It provides comprehensive initial evaluation and follow up care of children and young adults affected with the condition. The clinic is staffed by a board-certified pediatric neurologist and epileptologist. Referrals and care with other subspecialties including nephrology, dermatology, cardiology and radiology will also be coordinated through the clinic.
The clinic is held every 2nd Monday afternoon (1 pm to 4 pm) of the month at the Neurology Clinic on the 2nd floor of Children’s Hospital of Michigan.
Vagus Nerve Stimulator Implant
For children with uncontrolled seizures without resectable seizure focus, a vagus nerve stimulator (VNS) may be a viable treatment alternative. The VNS is implanted under the chest wall and contains a wire that runs from it to the vagus nerve in the neck. VNS therapy delivers frequent mild electrical pulsations to the brain's vagus nerve, similar to that of a pacemaker. Once implanted, the device, about the size of a silver dollar, is programmed to deliver customized impulses based upon the patient's unique needs. For patients who anticipate their seizures and know when they will happen, they can hold a special magnet near the implant which can trigger it to deliver a pulse outside of its normal programming. Doing so can help abort their seizures, and/or shorten their duration.
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