Pediatric Neurology 

There are 6 crore children in Bangladesh and at least 1 crore kids will have some form of neurological problem in their life time. For this huge number of patients only a few physicians work in the field. One of the biggest problem is the lack of awareness among the parents about the gravity of the disease. This subject deals the neurological problems of the children under 15 years of age. The commonly encountered diseases are 

Headache 

Most of the parents used to go to ophthalmologist to solve the problems of headache. Contrary to the popular belief, migraine is the commonest cause of headache even in kids. The second common cause is anxiety. But one must exclude brain tumor as a cause of headache. The other bad causes are brain infection and increased pressure in the brain. So headache must not be taken lightly. 

Autism 

The incidence of Autism globally increased significantly in last 15 years; currently 1affected in each 59 kids. This increase is alarming. Most of the time, it presents with delayed speech with other markers of delayed communication. Early picking up of the cases can help a lot. It is also important to exclude the mimics of Autism- like hearing loss, Fragile X syndrome, mental retardation and so on. 

Cerebral palsy 

If paralysis of a limb is caused by a lesion in the developing brain then it is called cerebral palsy. The commonest causes are perinatal asphyxia, premature delivery and Meningoencephalitis. The outcome of cerebral palsy is usually gloomy but judicious use of medication and planning can help the kids rather than moving to many doctors. The big differential is dopa responsive dystonia which has a good outcome. 

Movement disorders 

There are different types like tics, dystonia, tremors and chorea. The commonest one is tics which has various presentations; these are also associated with ADHD and OCD. The causes of dystonia are many like perinatal asphyxia, primary torsion dystonia, Wilson disease- prompt detection of the cause is very important as the outcome is usually poor. Perhaps the only treatable one is a Wilson and Dopa responsive dystonia. Chorea has multiple causes like rheumatic fever, perinatal asphyxia, vasculitis; pin point diagnoses is important to manage the cases.  

Neuromuscular disorders 

The commonest one is Duchenne Pseudomuscular dystrophy; the outcome is always bad as most kids become wheelchair bound by 13 years. Genetic counseling is important for this disease. Becker muscular dystrophy is a strong differential which has a much better outcome. The treatable muscular diseases are dermatomyositis and myasthenia gravis. As these disorders are relatively rare, diagnoses are sometimes tricky.