Birth Marks in children: Do I need to see a Pediatric Neurologist?
A birthmark is a coloured spot on the skin, which is present at the time of birth or develops shortly afterwards and can range from light to dark brown to black or blue, and sometimes bright red. They can be very small in size and may involve large areas of the face or body. Up to 80 % of newborn babies are known to have some form of birthmark, and fortunately majority of them do not need any treatment and certainly not the input form a Pediatric Neurologist. One of the commonest birth mark which occurs at the lower back of the newborn and is bluish in colour baby is called “Mongolian Blue spot” which disappears as the child grows older.
When do I need to see a Pediatric Neurologist?
Some birth marks are not straight forward and are associated with various neurological problems, and these are the ones which need specialist Pediatric Neurologist intervention. These are called “Neurocutaneous syndromes” as they may be associated with not just skin marks but underlying neurological problems. These conditions are usually genetic in nature, and many times there is no obvious family history and are thought to be “de novo” (new onset) in the child.
- Neurofibromatosis (NF)
- Tuberous sclerosis (TS)
- Sturge-Weber Syndrome (SWS)
What are the common Neurocutaneous Conditions?
The 3 most common types of birth mark related conditions seen in my practice are:
Neurofibromatosis and Tuberous sclerosis usually come to attention of the paediatrician as they can present with dark and light brown patches (cafe-au-lait) on the skin. Sturge-Weber Syndrome on the other hand usually presents itself with a bright red or purplish discolouration on one side of the face also known as “Port-Wine stain”
How are these conditions any different from usual birth marks?
Unfortunately, these conditions are lifelong and quite a few of them have a risk of developing tumours along the nervous system, or even under the skin. They can also cause other problems such as hearing loss, seizures, epilepsy and developmental problems. The symptoms can vary from one condition to other, and other effects of these conditions may not be fully visible until the child reaches adulthood.
How can a Pediatric Neurologist help?
I usually carry out a detailed history and examination of the child, following which I recommend a battery of tests to appropriately diagnose these conditions. The tests may vary according to the examination, but commonly carried out ones include Genetic tests, MRI scan, EEG (Brain wave test), Eye examination. A Multi-disciplinary approach is paramount, given these are lifelong conditions and the educational, social, emotional and physical problems must be managed throughout a child's life in a empathetic manner making sure that the child reaches his/her maximum potential.
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