At ACPN, we have all the expertise and equipment to evaluate epilepsy in children. We carry out standard and sleep deprived EEGs, ambulatory prolonged EEGs and videotelemetry. For inpatient three day Videotelemetry, I admit children to Neurospinal Hospital for a thorough evaluation. Brain imaging with epilepsy protocol is carried out a Neurospinal hospital and City Hospital. At ACPN, we have plans of establishing a comprehensive Ketogenic diet service for refractory epilepsy. Children are also evaluated for insertion of vagal nerve stimulators and appropriate referrals are made to Neurosurgeons based in Tawam Hospital and Al Noor Hospital (Abu Dhabi).
2) Headaches and Migraines:
We do a comprehensive assessment for headaches and migraines. This includes a thorough history and headache diary. This is followed by a open discussion with parents exploring various therapeutic and preventative options. In older children, botox for headaches is carried out and newer options like Cefaly (nerve stimulating headband) are considered.
3) ADHD and Autism:
Thorough assessments using standardized screening and diagnostic tools are carried out. For children with a diagnosis of ADHD specific questionnaires like Conner’s and Vanderbilt are used. If a more comprehensive behavioural assessment is required, then appropriate referrals to Educational and clinical psychologists is made. Assessment for academic achievement can also be carried out based on child’s need. Autism diagnostic tools like MCAT, GARS, ADI-R and ADOS are used to complete a thorough and comprehensive assessment for a child. Once a diagnosis has been confirmed, individualized recommendations are made for school and parents. ABA therapy is also offered for children in whom it is indicated. For children with other co-morbidities like speech delay and delayed motor development appropriate assessment and therapy from our speech and language therapists , physiotherapists and occupational therapists is instituted.
4) Movement disorder service/ Tics management:
Neurological causes of specific movement disorders like Dystonia, Spasticity, tremors and Chorea are explored and evidence based treatment is offered. For common conditions like complex motor tic disorders and stereotypies, appropriate assessment followed by specific therapies like cognitive behavioural therapy and habit reversal techniques are offered. In refractory cases medications are also considered.
5) Developmental Delay:
Identification of the underlying cause of this wide and varied presentation requires a systematic, targeted and judicious use of investigations. We use our clinical skills supported by our experience in considering specific investigative tools in reaching a diagnosis. Once a diagnosis has been made appropriate therapeutic and conservative treatment options are offered. These include establishing a package to include physiotherapy, speech therapy, occupational therapy and educational psychology. Following a multidisciplinary assessment a detailed report is provided to parents +/- school.
6) Speech Delay:
Speech delay is one of the commonest presentations seen in children living in the UAE. However, it is only an indicator of a specific underlying neurological/pervasive/psychiatric disorder. It requires a thorough assessment by a neurologist, child psychiatrists and Speech therapist before therapy can be instituted. Usually, the cause is either familial, constitutional or associated with an underlying pervasive disorder like Autism. However, in some cases underlying epilepsy, inherited metabolic problems or a genetic diagnosis is picked up.
7) Sleep disorders:
Sleep is a behavior that is often overlooked by parents and clinician’s in day-to-day life. Sleep disorders have often have a major effect on the child’s daytime behavior, learning and health. The impact of disordered sleep in the child also falls onto parents and this is seen as lack of energy, marital conflicts, employment issues and social inter-relationships. We carry out a thorough evaluation at ACPN starting with a comprehensive sleep history, a through examination and then judicious use of investigative tools like EEG and Polysomnography. For children requiring ENT assessments appropriate referrals are made to trusted clinicians in partner centers. The most common cause of sleep problems in children is behavioural insomnia. In these cases appropriate advice is given to parents to establish a sleep routine and improve the sleep hygiene of their child. In some cases, medications are prescribed as an adjunct to help with modulation of sleep pattern.
There are many different types of pediatric neuromuscular diseases. These include inherited neuropathies, muscular dystrophies like Duchenne, congenital myasthenic syndrome and other myopathies. We provide a multidisciplinary setting for the diagnostic evaluation and follow-up services for infants and children with known or suspected neuromuscular disorders. For diagnostic evaluation, genetic tests are sent to reputed and accredited labs.
9) Neurometabolic and Neurogenetic conditions:
These conditions are rare but collectively they have a substantial impact on the local healthcare system. These conditions require a systematic and evidence-based diagnostic approach with continuous discussion with parents. Many a times a definitive diagnosis is not reached in spite of all the investigative processes and in those cases symptomatic management is initiated. We have collaborated with accredited and reputed laboratories across the country for the judicious use of investigative procedures. Once the diagnosis is made appropriate referral to the clinical geneticist and metabolic physician is made.
10) Learning disability:
This is usually identified at a nursery or early school level. We provide a neurological/psychiatric assessment followed by input from our Educational psychologist, Rolex Air King replica watches speech therapist and occupational therapists.
11) Behavioural/Conduct disorders:
At ACPN, we have child psychiatrists who accept referrals for a thorough assessment and following specific recommendations children are assessed by clinical psychologists who are trained ABA therapy, Rolex GMT Master Replica psychotherapy and cognitive behavioural therapy. They are enrolled onto a targeted program to help them and the family with these concerns.