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Pediatric Neurology Therapeutics. Suzanne Goh, M.D . sgoh@gohmd.com 415-317-4514. OVERVIEW. When should I refer a child to a pediatric neurologist? Unusual movements or “spells” When thinking about meds for problem behaviors Complex cases. When to refer…. Unusual movements or “spells”
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Pediatric Neurology Therapeutics Suzanne Goh, M.D. sgoh@gohmd.com 415-317-4514
OVERVIEW When should I refer a child to a pediatric neurologist? • Unusual movements or “spells” • When thinking about meds for problem behaviors • Complex cases
When to refer… • Unusual movements or “spells” • Seizures • Tics • Other movement disorder …how are these different from stereotypies?
Medications for problem behaviors • Combinations of meds at low doses sometimes work better than single meds at high doses • Challenges with long-term use (side effects, lose efficacy over time, higher and higher doses needed, tapering off) • Potential alternatives to meds (supplements, acupuncture, neurofeedback, etc.) *supplements may be needed during psychopharm therapy to counteract med toxicities (e.g. carnitine) • Trying relationship-based behavior programs in addition to ABA-based
Complex Cases • Multiple neurological symptoms • Intellectual disability • Epilepsy • Low tone, incoordination, weakness • Headaches • Vision and hearing problems • Movement disorder, tics, etc. • Multi-system dysfunction • Minimal improvement with behavioral and educational intervention
Complex Cases The more severe and complex the phenotype, the more likely a causative mutation can be found.
Researchers identified a form of autism (with epilepsy and intellectual disability) that is likely treatable with dietary amino acid supplementation.
80% of children with autism had blood tests showing mitochondrial dysfunction mitochondria