The term “neurologic disorder” applies to any condition caused by a dysfunction in part of the brain or nervous system, resulting in physical and/or psychological symptoms. Even though all neurologic disorders involve the brain, spinal column, or nerves, the symptoms of any neurologic disorder depend on where the damage occurs. For instance, some symptoms can affect motor function, communication, vision, hearing, or thinking.
Neurologic disorders are wide ranging, have a multitude of causes, complications, and outcomes. Many of which require lifelong management. These disorders can vary from epilepsy to migraine headaches to tic or movement disorders and more. In children, the damage can be especially acute as most brain cells are formed before birth but the trillions of connections between these nerve cells (neurons) are not developed until infancy.
What causes neurologic disorders?
Many neurologic disorders are “congenital,” meaning children were born with the disorder, such as spina bifida or hydrocephalus (fluid in the brain), or they acquire the disorder later in life, usually the result of a traumatic injury or serious infection. Those with an unknown cause are termed “idiopathic. In general, there are three main factors or causes that lead to Neurologic Disorders: Congenital, Pre/perinatal, and “Acquired” (those developed after birth).
Congenital Causes (present at birth)
Genetic factors can influence the development of various neurologic disorders typically inherited from parents through genes and chromosomes.
- Gene abnormalities: Genes are responsible for determining characteristics. Changes in genes (called mutations) therefore change characteristics. Some mutations cause abnormalities that damage individuals (for example, cystic fibrosis). Mutations can be passed on to offspring, affecting their characteristics.
- Chromosome abnormalities: Changes in chromosomes, whether in number or structure, affect characteristics because they contain large numbers of genes.
- Change in chromosome number: Monosomy refers to losing one chromosome out of a pair (for example, Turner syndrome, which only affects females). In trisomy, an extra chromosome has been gained by a pair (for example, Down syndrome).
- Change in chromosome structure: Microdeletions result in a loss of genes (fragments of DNA) from a chromosome. Microduplications occur when genes (fragments of DNA) are gained. Examples of such genetic conditions include cri-du-chat, Prader-Willi, and Angelman syndromes.
- Metabolic disorders: Metabolism refers to the chemical processes that occur in the body. Metabolic disorders can cause lasting damage and must be identified as early as possible (for example, through blood or urine tests). Many metabolic disorders are detected at birth as blood samples are sent for ‘universal newborn screening’. In the United States, each state has its own guidelines as to what screening testing is done and not all countries have such screening programs.
- Congenital malformation: Congenital ‘defects’ are believed to result from complex interactions between genes, environment, and behaviors. An example is tuberous sclerosis, a condition where children have growths in regions such as the brain, heart, eyes, skin, kidneys, and lungs. They may experience epilepsy, learning difficulties/impairments, and autism.
Pre/perinatal Causes
- Toxins and environmental factors: Neurotoxins can enter and damage a child’s developing system through the placenta during fetal development. Consequently, a child may develop intellectual and behavioral problems. Neurotoxins include alcohol (linked to fetal alcohol syndrome), lead (linked to intelligence, learning, and memory problems), mercury (linked to learning and development disorders), tobacco (linked to challenging behaviors and developmental impairments) and some food additives (linked to higher rates of ADHD in children).
- Nutritional deficiencies: Nutrients are needed for growth. A deficiency of nutrients during the last three months of pregnancy can decrease the number of brain cells. A deficiency of folic acid (a B vitamin) could lead to a neural tube defect (NTD) — for example, spina bifida (open spine).
- Infections: TORCH infections, including sexually transmitted infections, can be passed from mother to baby during pregnancy. As reflected by the letters in the name, TORCH infections include Toxoplasmosis, Other infections (hepatitis B, syphilis, varicella-Zoster virus, HIV and Parovirus B19), Rubella, Cytomegalovirus and Herpes simplex virus. These infections can cause developmental abnormalities in the unborn child. Chorioamnionitis, a bacterial infection, can be a cause of cerebral palsy.
- Hypoxia/asphyxia: Perinatal asphyxia is the condition resulting from a lack of oxygen (hypoxia). Hypoxic ischemia is insufficient blood flow causing reduced blood oxygen content. If a developing baby in the uterus does not have enough oxygen, then it may have hypoxic ischemic encephalopathy (neurologic damage caused by low oxygen). The effects of severe hypoxic ischemia can include cerebral palsy, intellectual impairments, and epilepsy.
- Complications during childbirth: The protective skull is not fully formed at birth, making the brain vulnerable to physical injury. The supply of blood and oxygen from the umbilical cord can also become affected at birth. As the brain depends on this supply of oxygen, oxygen deprivation can cause brain damage.
- Prematurity/low birth weight: Low birth weight may indicate growth problems in the womb and has been associated with a greater likelihood of developing cognitive impairments, speech and language impairments, attention problems, social difficulties, hyperactivity, and learning impairments. Some may arise because of associated complications during childbirth.
- Interaction effects: A number of factors, including heredity, gene expression, the environment, infectious disease, poor nutrition, stress, drugs, and other chemicals, can interact in complex ways to cause some neurologic disorders.
Acquired Causes (Developed After Birth)
Disorders acquired after birth are less common than Congenital causes, but they include:
- Immune disorders: Immune disorders, such as autoimmune encephalitis, can cause emotional challenges, abnormal body movements, and seizures. Children with such problems can develop symptoms over several months and the diagnosis is challenging and frequently involves analysis of blood and cerebrospinal fluid.
- Postnatal infections: Encephalitis (inflammation of the brain) can be caused by many types of infection (usually viral). Some children may develop neurologic long-term consequences following encephalitis, including memory problems, behavioral changes, speech impairments, and epilepsy.
- Meningitis: Meningitis is caused by a bacterial or viral infection that inflames the meninges (membranes surrounding the brain and spinal cord). The inflammation and swelling can damage the brain and nerves. Complications are more likely following bacterial meningitis than with viral meningitis. Lasting symptoms include hearing impairments, memory difficulties, coordination and balance problems, learning impairments, epilepsy, cerebral palsy, speech impairments, and loss of vision.
- Traumatic brain injury: This occurs when trauma to the head results in damage to the brain. There are three main types of traumatic brain injury (TBI):
- Closed head injuries – where no damage is visible; these are common in car accidents.
- Open wounds – where the brain is exposed and damaged by an object.
- Crushing injuries– where the head is crushed, and brain damage occurs.
Evidence suggests that children’s brains are susceptible to lasting damage from TBI due to a disruption of the nervous system during development.
- Spinal cord injuries: Car accidents, falls, or sports accidents can cause spinal cord injuries. The degree of damage depends on where the damage occurs and what part of the body the injured spinal area controls. Spinal injuries can lead to loss of muscle function.
- Neoplasm: Neoplasm is an abnormal mass of tissue producing tumors. Tumors can develop in the brain or spinal cord. They can be benign (noncancerous) or malignant (cancerous). Malignant tumors are the most dangerous, so early diagnosis is very important. Benign tumors can have neurologic consequences as they increase pressure on other parts of the brain, damaging healthy tissue. Symptoms include seizures, limb weakness, difficulty walking, speech impairments and swallowing difficulties, strange sensations, learning impairments, challenging behaviors, or vision and hearing impairments.
- Toxins: Exposure to environmental chemicals or toxins during childhood can lead to neurologic impairment.
Warning Signs of Neurological Problems
Some of the early warning signs that your child might suffer from a neurologic disorder are as follows:
- Abnormal muscle tone at birth
- Seizures
- Floppy baby (limited self-motor function)
- Subtle staring or unresponsive episodes
- Slow language and/or motor skills
- Decrease in the achievement of standard pediatric developmental milestones
Early Intervention
Early diagnosis and intervention are key. If your child's behavior has changed dramatically, call their pediatrician for an evaluation. Once the underlying cause of a developmental delay is diagnosed, therapy can be helpful.
Care Options for Kids Occupational Therapists
If you are concerned that your child may suffer from neurologic disorders or have recently received an official diagnosis, Care Options for Kids offers experienced occupational therapists who come to your home and work with your child one-on-one. This approach allows both the parents and the clinician to work together to provide personalized care in a way that helps the child feel the most comfortable. A home setting is also ideal for helping the family seamlessly integrate the lessons into the daily family routine. The familiar environment allows the optimal conditions for a child to achieve the best results, and it is convenient. Simply said, in-home therapy saves time, transportation costs, and the hassle of back-and-forth travel.
Our therapists specialize in early intervention and provide occupational, speech, and physical therapy. We believe in continuity of care and seek to ensure that in-home therapy is provided by the same clinician who is familiar with your child’s individualized needs, goals, and overall progress.
If you would like to speak with someone who can help you get started, please do not hesitate to contact us to get in touch for an evaluation of your child.
