Department of Pediatrics
Division of Child Neurology and Neurodevelopmental Disabilities
The Division of Child Neurology performs comprehensive evaluations and treatment of children with suspected disorders of the nervous system. Conditions evaluated include headaches, tics, seizures, epilepsy, concussion, multiple sclerosis, nerve injuries, cerebral palsy, neurogenetic conditions, spinal cord disorders, and more.
The Division of Developmental Disabilities provides the comprehensive evaluation and management of children with a spectrum of developmental disorders. Conditions evaluated include autism, ADHD, language delay, cognitive impairment, and learning disabilities, and more. Close coordination is carried out with the primary care physician and the child's school.
Child Health Institute of New Jersey
89 French Street, Suite 2200
New Brunswick, NJ 08901
For Appointments: 732-235-7875
The Child Neurology Program is dedicated to the care of children with neurological disorders from the ages of birth to 21 years. Our certified and experienced team members are pleased to offer second opinions when requested. Our Division utilizes a variety of current diagnostic testing modalities to assist us in the most rapid and accurate diagnosis for your child, including MRI (magnetic resonance imaging), genetic testing, EEG (electroencephalography), EMG (electromyography), EP (evoked potentials), video EEG, and many other services.
In cases requiring multidisciplinary support, our pediatric sub-subspecialty counterparts are typically located within the same building, or across the street. Our staff currently consists of two board-certified child neurologists, a neurology certified Nurse Practitioner, and neurology nurse. We are currently recruiting additional staff to meet the needs of our community. Our team provides inpatient consultations for patients admitted to the Bristol-Myers Squibb Children's Hospital, part of Robert Wood Johnson University Hospital.
Neonatal Neurology (also known as the Neonatal Follow-up Program) provides multidisciplinary long-term monitoring of premature high-risk infants, and those born with neurological abnormalities at Robert Wood Johnson University Hospital. Ongoing follow-up is coordinated with the community primary care providers. This program is now located at Children’s Specialized Hospital: 888-244-5373 x 5955.
We provide comprehensive evaluation and treatment of children who have sustained a concussion. Diagnostic modalities include MRI studies, ImPACT testing, and SCAT testing. Close coordination is carried out with the primary care physician and the child's school.
Our Pediatric Epilepsy program specializes in the diagnosis, management, and treatment of children with seizures and epilepsy. We evaluate children from birth to 21 years of age who experience seizures, and provide ongoing support for families. Diagnostic modalities include MRI studies, genetic testing, EEG, and video EEG services. Our certified and experienced team members are pleased to offer second opinions when requested.
Children may develop seizures at any age. This can be due to an injury, such as head trauma, or without an obvious cause, as is the case in most children with a genetic tendency for seizures. When individuals experience repeated seizures, this is known as epilepsy. Epilepsy can be of focal (one part of the brain) or generalized (involving all parts of the brain at the same time) origin, and treatments are geared toward specific seizure types. In select situations, a child may benefit from other modalities, such as ketogenic diet, vagal nerve stimulation (VNS), or epilepsy surgery. Specialized medications and/or infusions such as ACTH, vigabatrin, prednisone, and IVIg may be used to treat patients with specific or refractory (hard to treat) epilepsies.
The Pediatric Epilepsy Program includes elective inpatient, outpatient, and ambulatory EEG monitoring, as well as a 24-hour inpatient long-term video EEG monitoring service to assist in the diagnosis and management of children with epilepsy. We partner with the Bristol-Myers Squibb Children's Hospital, which is located adjacent to our office. This state-of-the-art Children’s Hospital provides an exceptional environment where our patients are continuously monitored with EEG and video recordings. Children are cared for by our housestaff, pediatric residents, pediatric nurses, and EEG technicians. Families and patients are evaluated daily by our inpatient child neurology service, and their EEG studies are interpreted by our pediatric epileptologists.
Our Pediatric Headache program specializes in the diagnosis, management, and treatment of children of all ages who experience headache, including migraines, tension-type headaches, sinus headaches, and more. We evaluate almost all types of headaches in children and teenagers and provide ongoing support for families. Diagnostic modalities utilized to assess headaches may include MRI studies, EEG, and lumbar puncture.
Children may develop headaches at any age. The most common cause of headaches in the pediatric age group is a primary headache, such as migraine or tension-type headache, but a neurological examination is important to detect other causes. Treatments for pediatric headache are based on the age and need of the child, and may vary from pharmacologic (medications) to non-pharmacologic therapies.
The Pediatric Multiple Sclerosis (MS) program fully evaluates and treats pediatric patients with central demyelinating diseases, including Multiple Sclerosis (MS), neuromyelitis optica (NMO), acute disseminated encephalomyelitis (ADEM), optic neuritis, and transverse myelitis. In addition to their presenting neurological symptoms, close attention is paid to the child’s functional and cognitive status, in order to maximize and preserve their long-term developmental outcomes, and maintain function. A comprehensive care plan is developed for each patient to address issues regarding education, cognition, social functioning, mental health, daily activities, and quality of life. Strong emphasis is placed on prevention of further relapses by using currently approved disease-modifying medical treatments as well as adjunct therapies. The Pediatric Multiple Sclerosis (MS) program works in collaboration with pediatric ophthalmology, pediatric rehabilitation, and other specialists to provide comprehensive care to children with MS and related disorders. This program also evaluates other causes of white matter disease in the brain, as well as other immune-mediated diseases affecting the brain, such as opsoclonus-myoclonus, autoimmune encephalopathies, and autoimmune epilepsies.
Multiple sclerosis (MS) typically affects women more often than men. It is identified most often in young adults ages 20-30; however, a significant portion of individuals with MS develop symptoms in childhood. It is estimated that more than 8,000 children are currently diagnosed with MS in the United States.
The most common presentations of MS include optic neuritis, transverse myelitis, arm-leg weakness, sensory disturbances, or balance problems. Optic neuritis manifests as blurred vision and pain in the eye, as well as color desaturation (a washed out appearance to colors). Transverse myelitis targets the spinal cord and can involve a combination of motor (problems with moving the body), sensory (numbness and/or tingling of the body), and/or bladder problems (bladder leaking or urgency). In some instances, the first presentation of symptoms can be an episode of acute disseminated encephalomyelitis (ADEM). Treatment for MS is considered most beneficial when started soon after diagnosis. Currently there is no cure for MS, but the best outcomes are achieved when the condition is identified early and flare-ups are managed as soon as they appear. A number of treatment options exist, and more options are on the horizon.
ADEM is a central demyelinating disorder that occurs in the setting of infection. It can occur either around the time of an infection (para-infectious), or shortly afterward (post-infectious). The first classic symptoms tend to be an alteration in level of consciousness (tired, sleepy, less active), and these may be followed by other neurological symptoms. While ADEM can be the first presentation of MS, ADEM is typically an isolated phenomenon that resolves entirely.
Neuromyelitis optica (NMO) is another demyelinating disorder of the central nervous system that resembles but is distinct from MS. Most individuals have repeated attacks of optic neuritis and transverse myelitis. While there is currently no cure for NMO, there are several treatment options. The best long-term outcomes occur when the condition is identified early and flare-ups are treated immediately.
Vikram Bhise, MD