Pediatric Neurology

The following information will help to familiarize you with our clinic and our practice. We see children, adolescents and young adults with a variety of neurologic illness/disorders, from the National Capitol Region and around the world. Included here are important phone numbers, points of contact and general information which will help streamline your experience Walter Reed National Medical Military Medical Center today and in the future. Any questions not addressed here can be directed to your doctor or clinic staff.

Resident/Student Education
Our Clinic is the sole source of Pediatric Neurologic education for military resident physicians, medical student and fellows in the National Capitol Region. This means that you will often first see one of our training physicians or medical students, and then your staff physician. We take education very seriously in our section and greatly appreciate your child’s important contribution.

Medicines
If your child has been prescribed a medication, it may be ordered at any of the National Capitol Region pharmacies, or a civilian pharmacy. However, because of the specialized nature of many of the medications we prescribe, they may not be immediately available, and some require special ordering which may take several days to fill. Similarly, your requests for refills or new medications must be called in early, preferably two weeks before the medication runs out to ensure that your child’s medication does not lapse. Please allow a minimum of 72 hours for refills.

Special Request and Paperwork
Our Physicians are available throughout the day by phone, and some may provide their email addresses for our contact as well. Urgent issues (increased seizures, mechanical failure of implanted devices, etc.) should be communicated to our secretary, who attempts to contact your physician immediately. All emergencies should be addressed through the nearest emergency department and emergency medical services. We have an on-call Physician available at all times. Calls regarding routine issues, such as medication refills and lab/radiology results will usually be responded to within 72 hours. Paperwork requests may require longer periods for completion, depending on the extent of documentation necessary.

Patient Education
The clinic has access to a great deal of web based, and hard-copy educational materials. Please make sure that you ask for these materials to learn more about a variety of medical and Neurologic disorders.

Research
Our service is often involved in research, and we may ask you and your child to participate in our medical research efforts. Participation is completely voluntary in these activities. More information regarding protocols and special treatments can be obtained from your physician.

If you have any concerns or suggestions regarding clinic functioning or issues related to the quality of your experience in the clinic, please do not hesitate to contact me.

Pediatric neurologists treat nonsurgical disorders of the nervous system: brain, spinal cord, nerves, muscles.

Common neurological disorders include:

• Dizziness & Syncope
• Stroke
• Headache/migraine
• Epilepsy/convulsions
• Abnormal movements
• Ataxia/clumsiness
• Multiple sclerosis
• Weakness/hypotonia
• Tremors & tics & Tourette syndrome
• Brain and spinal cord injuries
• Brain tumors
• Neuro Muscular disorders
• Gait disturbance
• Spasticity/cerebral palsy
• Developmental delay
• Macrocephaly
• Spells/altered awareness

Procedures

• EEG - Electroencephalography Recording the brainwaves using electrodes placed on the scalp.
• EMG/NCV - Electromyography/Nerve Conduction Test Evaluation of the peripheral nervous system using a series of small shocks to test individual nerves and muscles. Small needles are also used to test the structure and function of muscles.
• Video - EEG monitoring (EMU
• Lumbar Puncture - LP or spinal tap is a procedure that is performed in order to collect a sample of cerebrospinal fluid (CSF) for analysis.
• Botox Injections - Used for the treatment of migraine/tension headaches and movement disorders and spasticity from cerebral palsy
• Baclofen Pump Refills – a Baclofen pump is a surgically implanted device that pumps a constant flow of minute amount of Baclofen directly into the spinal canal, in order to reduce the amount of spasticity in a patient with cerebral palsy; the reservoir of such a pump must be refilled every 2-4 months, depending on the flow rate
• VNS (vagus nerve stimulator) adjustments – a VNS is a surgically implanted device that is very useful in treating difficult to control epilepsy; through a 20-30 second electrical impulse discharged every 3-5 minutes to the vagus nerve, abnormal electrical discharges in the brain attempting to organize into a seizure, are often prevented from such organization; adjustments are made throughout the 10 year lifetime of the device, depending on the variation of seizure occurrences.