Brain Evaluation

The Use of Magnesium Sulfate Reduced the Risk of Cerebral Palsy

This article appearing in Neurology Today, September 18, 2008 indicated the results of a study that recruited at risk pregnant women between 24 and 31 weeks from 20 different centers.  Women were given an infusion of magnesium sulfate for up to 12 hours prior to delivery. At the end of two years, those who had been exposed to magnesium sulfate before the preterm birth were less likely to have signs of moderate or severe cerebral palsy.  Magnesium sulfate was indicated as a stabilizer of blood vessels, protecting against damage from oxygen depletion and injury from swelling and inflammation factors which can affect the developing brain.

The Prediction of Cerebral Palsy

CP can be predicted using cranial ultrasound examination.  Low birth weight infants were found to have enlarged ventricles and lesions predictive of the severity of CP at six weeks of age.  “Echolucent lesions on head ultrasound had a positive predictive value of 52 percent for cerebral palsy in 1,500 preterm babies born at less than 28 week gestation” according to the Neurology Today article of December 4, 2008. 

Is Tourette's merely a tic disorder or a sign of frontal lobe dysfunction?

At the American Academy of Neurology Winter Conference held in January of this year, 2008, the question of what TS (Tourette's Syndrome) really represents was presented by Dr. Harvey Singer, Neurologist, John Hopkins School of Medicine. Typically TS is defined as a disorder involving tics (motor and phonic) as the primary symptom that wax and wanes (increased by stress and decreased by relaxation).  One to ten per thousand children are diagnosed with TS, showing variable outcomes, with a greater propensity to hit the male population.  TS is typically associated with an assortment of co-morbid or co-associated disorders, most often ADD/ADHD.  What was novel about Dr. Singer's presentation was his connection of TS to the frontal lobe.  Using neuropsychological evaluation my experience is that childen and adolescents diagnosed with TS can present a picture of cognitive deficits involving the frontal processes (hence the over-diagnosis with ADHD).  For the parent and treating professional it is important to rule out cognitive deficits that may have a profound effect upon academic studies and learning using neuropsycholo gical evaluation.