Pediatric Neurological Concerns: When to Seek Help

Many questions?

My eldest child is 8 years old and has Asperger's syndrome.
He was delivered via vacuum extraction at 42 weeks.
During his crawling phase, he exhibited head-banging behavior.
Before he turned one, he experienced tremors in his hands while breastfeeding, where he would grab and release repeatedly.
However, after another breastfeeding session, he seemed to improve.
He has always had issues with strabismus and currently has below-average learning abilities.
I wonder if consulting a neurologist now could help identify the underlying issues or if there are any remedial opportunities to help him develop normally, or if it would be futile.
Additionally, could he qualify for a disability certificate?
My daughter is 4 years old.
When she was a little over one, she fell and hit her head, causing her to faint but she was fine after being awakened.
She had similar incidents at ages 2 and 3, where she also hit her head and turned pale with purple lips before fainting.
Today, she fell and hit her stomach, and after calming her down and asking where it hurt, her eyes suddenly rolled back, her lips turned purple, and she fainted.
When placed on the sofa, she had food in her mouth that needed to be removed.
Suddenly, she clenched her jaw tightly and held her hands in front of her chest.
After a while, her eyes opened but appeared dazed, her lips were pale, and she wet her pants (when asked when she urinated, she didn’t know, but the wetness indicated it happened while lying down).
Later, she took several minutes to regain her composure while sitting.
Should she see a doctor? Will this affect her intelligence? A doctor previously mentioned it could be a breath-holding syndrome (triggered by fright), but she has fainted multiple times without crying beforehand.
This time, it appeared more alarming, resembling a seizure, although her development has been normal.
Is it necessary for her to see a doctor? (Also, which hospital or doctor should we consult in Hsinchu?)

You Ma, 30~39 year old female. Ask Date: 2008/11/16

Dr. Xie Degui reply Pediatrics

1.
It is recommended to undergo an early developmental delay assessment, which can be done at our hospital's pediatric neurology clinic with Dr.
Bao-Ling Chang on Thursday afternoons.

2.
Based on the described symptoms, they appear to be indicative of epilepsy.
An evaluation is needed to determine if there is any impact on the brain, and it may be necessary to arrange for an EEG.
You can bring this up during your appointment with Dr.
Chang for further evaluation.

Reply Date: 2008/11/16

More Info

When it comes to pediatric neurological concerns, it is crucial to recognize the signs and symptoms that may indicate the need for professional evaluation. In your case, you have described two children with distinct yet concerning issues that warrant further investigation by a healthcare professional, particularly a pediatric neurologist.

For your 8-year-old son with Asperger's syndrome, it is essential to consider the various developmental milestones and challenges he has faced. The history of vacuum-assisted delivery, head-banging behavior during crawling, and episodes of hand tremors during feeding are significant indicators of potential neurological issues. Additionally, the presence of strabismus (crossed eyes) and current learning difficulties further complicate his developmental profile.
Seeking a consultation with a pediatric neurologist is advisable. They can conduct a comprehensive evaluation, which may include neurodevelopmental assessments, imaging studies (like an MRI), and possibly an EEG to rule out seizure activity or other neurological disorders. Early intervention is critical; while some challenges may persist, appropriate therapies and educational support can significantly improve outcomes. Regarding the possibility of obtaining a disability certificate, this typically depends on the severity of the condition and its impact on daily functioning, which a neurologist can help assess.

As for your 4-year-old daughter, her history of head injuries and subsequent episodes of fainting, particularly with the alarming symptoms you described (pale face, purple lips, and loss of consciousness), is concerning. These episodes could suggest a range of issues, from simple vasovagal syncope to more serious conditions such as seizures or cardiac problems. The fact that she has experienced multiple fainting spells, especially after head trauma, necessitates a thorough medical evaluation.
It is crucial to consult a pediatrician or a pediatric neurologist who can assess her neurological status and determine if further testing, such as an EEG or imaging studies, is necessary. The symptoms you described, including the episodes of stiffening and loss of consciousness, could be indicative of seizure activity, which requires prompt attention.
In both cases, it is essential to act quickly. Delaying evaluation can lead to missed opportunities for early intervention, which is often key in managing developmental and neurological disorders effectively.
In terms of finding appropriate medical care in Hsinchu, I recommend looking for a reputable children's hospital or a specialized pediatric neurology clinic. You can start by checking with local hospitals or seeking referrals from your pediatrician.
In summary, both children exhibit symptoms that warrant professional evaluation. Early diagnosis and intervention can lead to better management of their conditions and improve their overall quality of life. It is always better to err on the side of caution when it comes to neurological health in children.

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