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Nemours/Alfred I. duPont Hospital for Children

1600 Rockland Road
Wilmington, DE 19803
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Conditions We Treat

Nemours Neuroscience Center at Nemours/Alfred I. duPont Hospital for Children

1600 Rockland Road, Wilmington, DE 19803 | Get Map & Directions »


Our Areas of Focus

At the Nemours Neuroscience Center, specialists from multiple medical specialties and therapy services work together to provide the best possible care for children with a wide variety of neurologic and developmental conditions and injuries.

These conditions involve part or all of a child's nervous system (brain, spinal cord and nerves) and how the nervous system interacts with the child's organs and muscles to affect movement, thinking, speech, swallowing, pain, mood and behavior.


Conditions We See Most Often

 
Autism Spectrum Disorder

Autism is a neurodevelopmental disorder (related to the nervous system and developmental abilities) marked by impaired social interaction and communication skills, and repetitive behaviors. “Spectrum disorder" means the symptoms and functioning can range from mild to severe.

Traditionally, the term “autism” has been used to diagnose children with symptoms on the more severe end of the spectrum, and the terms “Asperger syndrome” and “pervasive development disorder-not otherwise specified” (PDD-NOS) have been used to diagnose children on the milder end of the autism spectrum. Today, these types are collectively referred to as “autism spectrum disorder” (ASD.)

Program Highlights
  • Through an initiative with our Nemours duPont Pediatrics primary care offices in Delaware and Pennsylvania, our autism specialists provide pediatricians throughout our communities with early autism screening using a parent questionnaire to identify the signs of autism and other developmental disorders in children as young as 12–18 months.
  • Our Transition of Care program for teens moving into the adult health care system helps prepare teens with chronic conditions (including ASD) to take responsibility and manage their health as appropriate for their individual capabilities. The program ensures that the teens understand their diagnosis, treatments and condition, including how to talk to doctors, insurance providers and more.
  • Diane C. Chugani, PhD, our new director of neuroscience research and a renowned autism researcher, is continuing her success in mentoring researchers in autism and other disorders of the brain and behavior. Her personal research had used positron emission tomography (PET) imaging technology — which allows a noninvasive look at various processes in the brain — to discover how autism develops, and to design and test new treatments based upon the findings.
  • Our team of autism specialists includes developmental pediatricians (the only ones in the state of Delaware), psychologists, psychiatrists, neurologists, neuropsychologists and therapists (mental health, speech and language, physical and occupational therapy) to best provide comprehensive, compassionate autism evaluations and treatments so your child can have the brightest, most productive future possible.
  • Our Augmentative Communication (communication methods used to help or replace speech or writing) team, part of Assistive Technology, can evaluate and recommend any needed communication aids for your child’s care — from sign language to picture books to eye-tracking, computerized and speech-generating devices.
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Concussions

A concussion is a type of mild traumatic brain injury that occurs when a person's brain moves around inside the skull and/or bangs against it. Although the injury may seem mild, it can affect a child's or teen’s health, thinking ability, behavior and mood, school performance and social interactions.

A concussion can be caused by a fall, car crash or sports injury. With rest and reduced activity, kids often recover on their own in a week or two. Other children and teens might require weeks or even months of therapy, rehabilitation and taking a break from school, sports and other physical and cognitive activities.

Program Highlights
  • Nemours is the only pediatric provider in the region to offer a comprehensive concussion screening program that uniquely combines four separate tests. These "baseline" tests are done before your child gets a concussion — this gives our doctors a baseline of your child's thinking ability and balance when not injured, so that they can compare the before-and-after results if a concussion does occur.
  • Our program combines the contributions of our pediatric rehabilitation medicine and neurology specialists, along with sports medicine physicians and staff from our orthopedic department. Members of our neuropsychology, ophthalmology, otolaryngology (balance specialists), physical therapy, occupational therapy and speech therapy staff may be called in as well.
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Epilepsy & Seizures

Epilepsy is a neurological disorder characterized by seizures (uncontrolled jerking movements and/or a momentary loss of awareness). Epileptic seizures can vary from brief and nearly undetectable instances to long periods of vigorous shaking.

The cause of the seizures is abnormal excessive activity in a specific part of the brain. But the cause for epilepsy itself is unknown — although some people develop the disorder as a result of brain injury, stroke, brain tumor or substance use.

Program Highlights
  • Harry T. Chugani, MD, our new chief of neurology and an internationally prominent neurologist and epileptologist (epilepsy specialist), is bringing his expertise at treating children with epilepsy to Nemours through the use of positron emission tomography (PET) imaging to guide surgical treatment aimed at stopping seizures. Our new Diagnostic and Research PET/MRI Center, coming soon, will offer children the benefits of PET technology, which provides reduced levels of radiation exposure, and will allow neurologists, neurosurgeons and other specialists to offer truly state-of-the-art care, especially in the treatment of epilepsy and cancer. It will also advance our research efforts, allowing a noninvasive look into various processes in the brain.
  • Our pediatric neurologists and other specialists at Nemours work together, using the most effective, proven medications and treatments to help control and prevent seizures in kids.
  • Nemours neurology specialists have the skills, training and technology to evaluate your child’s seizures — and the compassion to find ways to control epileptic seizures with the fewest possible side effects.
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Headaches & Migraines

For some children and teens, headaches and migraines can be a serious and recurring problem. They can have a major impact on how kids feel, act and play, affecting both how they get along with others and how they do in school.

Your initial visit with us may be with a specially trained pediatric neurologist or other expert, who will check for what might be causing the headaches and start treatment if necessary. A specially trained advanced practice nurse (APN) will help you manage your child’s day-to-day care, coordinating with other providers as needed.

Program Highlights
  • With a combination of medication, education and other approaches, we provide a complete program to evaluate the cause of your child’s headaches, identify what activities and substances may trigger the headaches, help relieve pain, and help prevent the headaches from even starting. We'll also educate you and your child about ways to avoid headache triggers.
  • Our staff will take your child's complete medical history and conduct a thorough neurological exam to establish the nature, duration, frequency and possible triggers of the headaches. We’ll determine whether your child is having migraines or another kind of headache and order imaging studies (radiology tests), if needed.
  • In addition to treatment with medication, we may recommend Healing Touch (an evidence-based therapy, often provided by a specially-trained nurse, that uses both gentle touch and nontouch methods to increase relaxation, relieve pain and reduce stress) or other integrative medicine therapies, which we can offer right here at the hospital.
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Neuromuscular Disorders

There are a number of neuromuscular disorders found in children, with different symptoms, causes, treatments and long-term outlooks. Some are genetic (inherited) and some are acquired (developing during childhood). We'll work to understand the causes and effects of your child's condition, and maximize strength and function.

Types of neuromuscular disorders include motor neuron diseases like spinal muscular atrophy (SMA), peripheral neuropathies like Charcot-Marie-Tooth disease, and neuromuscular junction diseases such as myasthenia gravis, muscular dystrophies and metabolic and inflammatory processes affecting the muscles.

Program Highlights
  • Our Muscular Dystrophy Program is truly world-class, and the the only one of its kind in Delaware.
  • We offer highly specialized orthotic devices for kids who could benefit from their use but don’t have the financial means to obtain them.
  • We host family conferences and visiting professorships for experts in their respective fields.
  • Our highly advanced Gait Analysis Laboratory was among the first of its kind.
  • We also offer psychological support for families of kids with neuromuscular and neuro-orthopedic (involving the nerves and bones) disorders.
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Spina Bifida

Spina bifida is a congenital (present at birth) condition that involves the incomplete development of the spinal cord or its coverings. We know that with spina bifida, the spine fails to close properly during the first month of pregnancy, but the cause is unknown.

A child born with spina bifida (also called “myelomeningocele”) or the related disorder lipomeningocele (when the “open” spine is covered over by an area of fatty tissue) often has some sort of damage to the nerves of the spinal cord. The extent of this damage can vary widely, but may include paralysis in the lower extremities and loss of bowel and bladder control. Children with spina bifida may have hydrocephalus (fluid on the brain) as well, and some may also experience attention deficit hyperactivity disorder (ADHD) or other learning difficulties.

Program Highlights
  • Our program combines the contributions of our pediatric rehabilitation medicine, neurology, neurosurgery and behavioral health specialists, along with physicians and staff from orthopedics and urology. Members of physical therapy, occupational therapy and speech therapy staff may be called in as well.
  • Our spina bifida experts are uniquely prepared to treat the medical challenges of the condition and to give children the tools they need to grow into active, independent adults.
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Six Medical Specialties, One Center of Excellence

Of course, our specialists treat patients experiencing many more conditions as well, including some that involve more than the nervous system. Following is a partial list of the conditions the medical specialties in our Neuroscience Center see most often:

 
Neurosurgery
  • arachnoid cysts (fluid-filled sac inside the head or spine)
  • arteriovenous malformations (abnormal connection between arteries and veins)
  • brachial plexus injuries (spinal cord nerves that signal to the shoulder, arms and hands)
  • brain and spinal cord injuries
  • brain and spinal cord tumors
  • Chiari malformation (when brain tissue extends down into the spinal cord)
  • congenital anomalies of the neck and back (birth defects)
  • craniosynostosis (skull bones fuse together before the brain has stopped growing)
  • dural fistulas (abnormal connection between arteries and veins in the outer layer of the brain)
  • epilepsy (neurological seizure disorder)
  • head, neck and back trauma
  • herniated discs (slipped or ruptured discs between the vertebrae)
  • holoprosencephaly (when a fetus’ forebrain doesn’t divide into cerebral hemispheres in the womb)
  • hydrocephalus (increased spinal fluid in the ventricles of the brain)
  • idiopathic intracranial hypertension (increased spinal fluid pressure in the brain)
  • intracranial hemorrhage (bleeding inside the skull)
  • malformations of the head and neck
  • Moyamoya disease (blockage of the internal carotid arteries)
  • neurofibromatosis types I and II (nerve tissue tumors)
  • pituitary and pineal gland lesions (craniopharyngiomas, germ cell tumors)
  • positional plagiocephaly (flattened head)
  • spasticity (muscle stiffness and/or involuntary movement)
  • spina bifida (neural tube defect of the spine)
  • spinal cord dysfunction and spinal cord injury (including conditions resulting in ventilator dependency)
  • spine tumors
  • Sturge-Weber syndrome (marked by vascular birthmark and neurological abnormalities)
  • syringomyelia (cyst in the spinal cord)
  • tethered spinal cord (when the spinal cord is attached to the spinal column)
  • tuberous sclerosis (benign lesions of the nervous system)
  • vascular anomalies of the head and neck

Learn More About Neurosurgery »

 
Neurology
  • developmental delays
  • epilepsy and other seizure disorders
  • headache and migraines
  • learning and language disorders
  • metabolic and inflammatory processes affecting the muscles
  • motor neuron diseases such as spinal muscular atrophy
  • muscle and nerve disorders
  • neuromuscular disorders such as cerebral palsy, muscular dystrophy, multiple sclerosis, anterior lateral sclerosis/ALS/Lou Gehrig’s disease
  • neuromuscular junction diseases such as myasthenia gravis
  • peripheral neuropathies such as Charcot-Marie-Tooth disease
  • sleep disorders
  • Tourette syndrome and other tic disorders
  • tumors in the nervous system (such as neurofibromatosis, tuberous sclerosis and other neurocurtaneous syndromes)

Learn More About Neurology »

 
Physical Medicine & Rehabilitation (Rehabilitation Medicine)
  • acquired brain injury (such as a stroke, brain tumor or loss of oxygen to the brain)
  • acute (short-term) and chronic (ongoing) musculoskeletal pain (pain of the muscles and bones), such as myofascial pain syndromes and reflex sympathetic dystrophy/chronic regional pain syndrome (RSD/CRPS)
  • amputation
  • brachial plexopathies (when the nerves of the body don’t work properly, like Erb/Klumpke)
  • burns
  • cancer
  • cerebral palsy
  • cerebrovascular (relating to the blood vessels in the brain) accident/stroke
  • concussions
  • congenital and acquired neuromuscular disorders (including cerebral palsy, spina bifida, muscular dystrophy)
  • congenital nerve diseases
  • developmental differences
  • electromyography (EMG, a technique for evaluating and recording the electrical activity produced by skeletal muscles)
  • encephalitis (an acute inflammation/swelling of fluid in the brain)
  • gross motor and/or fine motor delay
  • high-risk newborn follow-up and conditions relating to prematurity
  • juvenile idiopathic arthritis or JIA
  • lymphedema, both congenital and acquired (arm or leg swelling caused by a build-up of lymph fluid due to a blockage in the lymphatic system)
  • meningitis (an inflammation of the protective membranes covering the brain and spinal cord, known collectively as the meninges)
  • multiple trauma
  • orthopedic rehabilitation postsurgery
  • pain management
  • prescription/management of assistive devices, bracing/splinting, wheelchairs, seating, adaptive equipment and prosthetics/orthotics
  • rehabilitation of any condition or injury affecting physical function (such as walking) and/or cognitive (thinking brain) function
  • respiratory issues (including mechanical ventilation)
  • spasticity (stiff or rigid muscles) management (including Botox® and intrathecal baclofen pumps)
  • spinal dysfunction and spinal cord injury (including those resulting in ventilator dependency)
  • toe walking, in-toeing and out-toeing
  • traumatic brain injuries (TBIs), including postconcussive syndrome and closed-head injuries

Learn More About Physical Medicine & Rehabilitation »

 
Developmental Pediatrics

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Psychiatry

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Psychology
  • adjustment issues related to a chronic medical condition (such as diabetes, cancer, sickle cell disease and gastroenterology conditions)
  • anxiety
  • attention deficit hyperactivity disorder (ADHD)
  • autism spectrum disorders
  • depression and mood disorders
  • developmental disabilities
  • difficulty following medical treatment plans related to a chronic medical condition
  • disruptive behavior problems
  • eating disorders
  • enuresis (bed-wetting) and encopresis (bowel accidents) in toilet-trained children
  • obsessive-compulsive disorder (OCD, when a person feels the need to check things repeatedly, has certain thoughts repeatedly, or needs to perform certain routines repeatedly)
  • pain
  • stress management

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Our Gait Analysis Laboratory: Among the First of Its Kind

Nemours’ specialists are constantly innovating new ways to diagnose and treat neuromuscular conditions. In fact, our children’s hospital was among the first in the nation to offer a Gait Analysis Laboratory, where we use technologically advanced techniques to analyze the way your child walks — including details such as the timing of muscles, and the forces produced by the motion and the movement of various joints. This helps us make the best possible treatment decisions — surgical and nonsurgical — for your child’s condition.


Fetal Conditions: Diagnostic Testing & Specialty Consultations

Through a multispecialty program called the “Nemours Partners for Perinatal Management,” we offer leading-edge fetal diagnostic testing and perinatal consultation services for expectant parents with babies who have conditions that may require specialized care right after birth. We’ll help you understand your unborn baby’s diagnosis, work with you to create a plan of care, and help you understand what to expect once your baby is born.

Learn More About Nemours Partners for Perinatal Management »

Research for Improved Care and Quality of Life

In addition to the medical and therapeutic treatment of children and teens with these conditions, we also participate in related basic and translational research, including clinical trials.
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