Paediatric Neurology

Our team treats a range of conditions, including:

• Common disorders
  • Epilepsy
  • Cerebral Palsy
  • Specific Learning and Behavioural Disorders such as Autism and Attention Deficit Hyperactivity Disorder (ADHD)
  • Headache
  • Tics Disorders (Tourette Syndrome)
  • Traumatric brain injury
• Rarer disorders
  • Brain Tumours
  • Neuromuscular Disorders
  • Acute Non-traumatic Encephalopathies
  • Neurodegenerative Disorders
  • Paediatric Movement Disorders
  • Mitochondrial Disorders

Physiotherapist Services

Early intervention and rehabilitation are crucial for children with neurological disorders impacting their physical abilities. This includes conditions such as cerebral palsy, global developmental delay, and muscle disorders such as Duchenne muscular dystrophy and spinal muscular atrophy.

Our physiotherapist services provide family-centric and multidisciplinary support by:

⦁ Empowering parents to make informed decisions about their child’s care.
⦁ Providing preventative care to reduce secondary complications of long-term neurological conditions.
⦁ Utilising technology-driven services, like robotic-assisted rehabilitation and augmented communication devices.

We help to enhance the care of a child with complex needs by:

⦁ Identifying and addressing areas of need for optimal management.
⦁ Improving the quality of life for children and their families by improving sleep comfort and facilitating mobility.
⦁ Ensuring access to state-of-the-art equipment. 
⦁ Collaborating with multidisciplinary teams and community-based agencies for comprehensive care continuity.
Our Rehabilitation Service provides comprehensive care for patients with spasticity, who may require specialised seating or wheelchairs. Objective assessments are conducted by paediatricians specialising in neurology, orthopaedic surgeons, orthotists, physiotherapists and occupational therapists. Gait analysis is performed using portable equipment. Treatment options for cerebral palsy include intramuscular botulinum toxin injections, , orthotic devices or tendon-release orthopaedic surgery. Advanced therapies, such as robotic rehabilitation, are available in collaboration with the Centre for Advanced Rehabilitation Therapeutics (CART) at Tan Tock Seng Hospital. Our clinics also focus on preventative care, including hip surveillance, nutritional support and educational interventions.
Our Neuroscience Laboratory provides diagnostic services. These include electroencephalogram EEGs)s performed by experienced technicians and interpreted by paediatricians specialising in neurology and epileptology. We offer brainstem auditory-evoked response and visual-evoked potential tests for children with suspected hearing or visual impairments. Neuromuscular issues are diagnosed and assessed through nerve conduction studies and electromyograms.
Our Paediatric Epilepsy-Monitoring Unit (PMU) facilitates comprehensive, round-the-clock monitoring of patients with epilepsy requiring further evaluation. or to clarify the nature of the patients' frequent spells or events.The unit accommodates neonates, infants, children and adolescents. 
Monitoring includes continuous EEG recording with simultaneous video recording of seizures. This detailed analysis aids in accurate diagnosis and the development of management plans, including anti-epileptic medication, ketogenic diet options and surgical treatments for intractable seizures.

Neurology Clinic
Our Neurology Clinic operates with a team of paediatricians and is supported by physiotherapists, occupational therapists, speech therapists, a paediatric epilepsy nurse educator, child psychologists and a medical social worker.
The clinic coordinates care for children with chronic conditions, collaborating with special schools for children with spasticity, multiple handicaps and learning disorders. At our general paediatric neurology clinic, we provide diagnosis and management of children with neurological disorders, screen for neuro-developmental disorders and offer comprehensive care for inherited neurological conditions.
Our team is also actively involved in the Back to Sleep programme, which helps to improve the sleep quality of children with complex medical needs.
 
Neuromuscular Clinic
Our Neuromuscular Clinic offers multidisciplinary, comprehensive care for children and adolescents diagnosed with progressive neuromuscular conditions. These include Duchenne muscular dystrophy, spinal muscular atrophy, congenital myopathies and other muscular dystrophies. The clinic, conducted monthly, caters to specific groups, including independent walkers and wheelchair-dependent patients. Objective assessments are provided by paediatricians specialising in neurology, pulmonary and sleep, orthopaedics and cardiology as well as by physiotherapists, occupational therapists and orthotists.
This integrated approach allows for a thorough review of associated complications in these patients and the development of comprehensive management plans in a single visit.
 
Neurogenetic Clinic
Our Neurogenetic Clinic, conducted on the last Monday of each month, is a collaborative service led by a paediatrician specialising in neurology and another in genetics. This clinic is dedicated to the diagnostic workup and management of neurogenetic, neurodegenerative and neurometabolic disorders.

Back to Sleep Programme
The Khoo Teck Puat – National University Children’s Medical Institute is immensely grateful to Ronald McDonald House Charities (RMHC) Singapore for being the sole benefactor of the Back to Sleep programme. This initiative aims to enhance the sleep quality of children with complex medical needs. Children affected by severe neurological conditions often experience difficulties in repositioning themselves during sleep due to abnormal muscle tones and postures. This leads to significant sleep disturbances and reduced sleep duration, affecting not only the child but also the entire family due to chronic sleep deprivation.

The Back to Sleep programme employs a multidisciplinary approach to evaluate each child's risk factors and explores the potential for improved sleep quality through more supportive sleeping surfaces. The team, comprising doctors, physiotherapists, nurses, patients and their parents and caregivers, assesses each child’s needs. Once medical and behavioural causes of sleep disturbance are excluded, children areprovided with tailored sleep systems to enhance their sleep.
The programme aligns with our mission to provide exemplary clinical care for children with medical needs and supports RMHC's mission to "directly improve the health and well-being of children". The positive impact extends beyond the child to caregivers, illustrating RHMC's belief that "when you change a child's life, you change a family's, which can change a community and, ultimately, the world".
Clinically documentation shows improved sleep quality and duration in these children, positively affecting family life. Parents report enhanced mood and appetite in their children and improved rest for themselves, highlighting the significant impact of this intervention on family functioning.
In summary, the Back to Sleep Programme has directly benefited 48 children, with a positive impact on an additional 210 family members and caregivers.

Image 1 (from left): A sleep system designed for the Back to Sleep Programme. Images 2, 3, 4 and 5: Two of the 48 beneficiaries of the programme. These patients experience abnormal muscle tones, movements and postures leading to significant sleep disturbances and reduced sleep duration. Images 2 and 4 illustrate the patients’ strained postures due to lack of support, adversely affecting their spines, hips and knees. Images 3 and 5 demonstrate how supportive sleep systems enable more relaxed positioning of their arms, bodies and legs, contributing to improved sleep comfort.

Our active clinical and basic research programme covers epilepsy treatment and epidemiology, neurogenetic and neurometabolic disorders, botulinum toxin in childhood spasticity, encephalitis, other central nervous system infections and neuromuscular diseases. Our research focuses on the genetics and pathophysiology of conditions such as Duchenne and Becker muscular dystrophy, mitochondrial encephalomyopathies and the care of chronic neurological disorders.

​At the first appointment, your child will undergo a comprehensive evaluation by a paediatrician specialising in neurology. Based on this assessment, further investigations such as blood tests, EEG or neuroimaging (MRI brain) may be recommended. Subsequent to these investigations, appropriate medications and therapies will be prescribed.

For directions to the Khoo Teck Puat – National University Children’s Medical Institute, including access via MRT, drop-off points and parking information, click here.
For more information on our paediatric clinic or contact details, click here.
To make an appointment online, click here.