We are the combination of four hospitals: the General Hospital, the Children’s Hospital, the Women’s Hospital and the Traumatology, Rehabilitation and Burns Hospital. We are part of the Vall d’Hebron Barcelona Hospital Campus: a world-leading health park where healthcare plays a crucial role.
Patients are the centre and the core of our system. We are professionals committed to quality care and our organizational structure breaks down the traditional boundaries between departments and professional groups, with an exclusive model of knowledge areas.
Would you like to know what your stay at Vall d'Hebron will be like? Here you will find all the information.
The commitment of Vall d'Hebron University Hospital to innovation allows us to be at the forefront of medicine, providing first class care adapted to the changing needs of each patient.
Childhood dystonia is progressive and debilitating, but it can be prevented with an early diagnosis and the use of specific therapies that target the genetic defect identified. Currently, several different treatments are used.
Levodopa trial
In children with isolated dystonia, a one to three-month long trial with levodopa must always be carried out. This medication can completely reverse symptoms when the dystonia is caused by a defect in dopamine synthesis. This is called dopa-responsive dystonia.
Such defective dopamine synthesis can be caused by alterations in the genes and proteins that regulate dopamine metabolism. This neurotransmitter is essential in learning, behaviour, and motor function.
Treatment with botulinum toxin
Botulinum toxin is effective at controlling focal dystonia, which affects a muscle group carrying out a specific action, such as, for example, writer’s cramp, or dystonia triggered by walking, treatment for which consists of correcting the abnormal foot or leg position when walking.
In children with generalised dystonia, botulinum toxin can also relieve pain in muscle groups that are particularly affecting the patient’s quality of life.
Treatment with various pharmaceuticals
To treat generalised dystonia in children, different drugs are administered to reduce the tremors, muscle tone, and painful spasms. These include benzodiazepines, GABA antagonists (baclofen), anticholinergics, and α-2 adrenergic receptor agonists. In some patients with paroxysmal dystonia, which is characterised by brief, repetitive involuntary movements at night, anti-epileptics are prescribed.
Intrathecal baclofen pump
When oral medications are not enough, there is a surgical option: the intrathecal baclofen pump. This internal device administers the medication baclofen through a catheter placed in the epidural space (which contains the liquid that surrounds the spinal cord). This helps control generalised dystonia, reducing pain, muscle tone, and spasms and thus improving patients’ quality of life.
This device is used to treat secondary dystonia or dystonia associated with other neurological problems (whether neurometabolic, neurodegenerative, or acquired through brain damage at birth).
Deep brain stimulation or pallidal stimulation
This consists of placing two electrodes in the pallidal nuclei of the brain via a stereotactic procedure, to improve the patient’s motor function and quality of life. Patients who are candidates for pallidal stimulation are those with primary dystonia who have no structural brain lesions in the central nervous system.
Our goals are to improve the health and quality of life of children with neurological diseases and offer comprehensive care through collaboration across multidisciplinary teams. Thanks to the implementation of new diagnostic and therapeutic procedures, we can advance our knowledge of molecular causes of, and develop new treatment strategies for, early onset neurological diseases.
Paediatric Neurology offers comprehensive care for children with neurological disorders, from common problems such as headaches or neurological follow-ups of at-risk new-borns to complex, heterogeneous and rare illnesses that are difficult to diagnose, such as neuromuscular diseases, epileptic encephalopathies and neurometabolic and neurodegenerative diseases.
The Paediatrics Teaching Unit has extensive experience in training specialists. There are a total of 60 Paediatrics residents at Vall d’Hebron University Hospital, 15 per year. Over the last few years, Paediatrics at Vall d’Hebron has been the first choice for new residents, and in the 2017 exam session achieved the best results of any Spanish hospital. In addition to this, we receive residents from hospitals all over the world.
Pediatric training itineraries
Over the last few years, paediatrics at Vall d’Hebron has been residents’ first choice, and in the 2017 exam session achieved the best results of any Spanish hospital.
The Department has a Paediatrics Teaching Subcommittee, comprising twelve tutors and twenty residents overseeing the practical application of the training and its integration into healthcare activities. Thanks to the involvement of these professionals, we can ensure supervised completion of the training programme objectives.
This Teaching Unit comprises different healthcare departments and units, including the Paediatrics, Nephrology, Neonatology, Paediatric Oncology and Haematology, Intensive Care, Neurology, Endocrinology, Infectious Diseases, Allergies, Cardiology, Respiratory Medicine, Gastroenterology, and A&E Departments.
It is vital for residents to train in research methodology as this is necessary to take part in and develop research projects. From the second year onwards, we invite residents to carry out research work, and a minimum number of papers and publications is required in addition to their full cooperation in sessions within the Department.
Why specialise at Vall d’Hebron?
It is a chronic brain disorder that can affect people of any age. It is characterised by recurring convulsions caused by excessive electrical impulses in groups of brain cells.
The consequences can be neurological, cognitive, psychological and social.
In 2005, epilepsy was defined as “a disorder of the brain characterized by an enduring predisposition to generate epileptic seizures”. Epilepsy is therefore diagnosed when patients experience two or more seizures, separated by a period of time that can last from 24 hours to 10 years.
Epilepsy causes brief absence seizures, involuntary movements, repetitive reflexes such as sucking movements, loss of consciousness, and so on. It can originate in one area of the brain (focal seizure) or the brain as a whole (generalized seizure). Seizures are sometimes accompanied by loss of consciousness and/or loss of bowel control. Their frequency can vary from only just one over a ten year period to several per day.
Seizures (absence seizures, muscle contractions, etc.) are the main symptom and may vary depending where in the brain the epileptic seizure begins.
For example, in tonic-clonic seizures (GTCS), it is common to observe twitching, muscle contractions, jerking, etc. These movements are called “myoclonus” and may be symmetric or asymmetric and are accompanied by rolling of the eyes. They are followed by a spasm with clenching of the teeth, laboured breathing and an epileptic shout.
Epilepsy affects the entire population, regardless of age, from whilst still in the womb right up to people in their nineties. It is estimated that 8 in 1000 people have the condition.
Related factors:
In some cases the cause of epilepsy may be unknown, as although we can see an epileptic seizure occurring in the brain, current technologies do not reveal what causes them. Epilepsy may also be genetic.
It is the second most common neurological disorder (after stroke) seen in accident and emergency departments. An estimated 3,000 patients are seen in our centre every year. 3% of the population will attend a medical centre at some point during their lifetime to determine whether their symptoms are caused by epilepsy.
Diagnosis requires:
It is advisable to avoid all situations that may create:
When faced with a seizure, a series of recommendations should be followed to avoid injury to the person having the seizure.
Paediatric Neurology, Children's Hospital and Woman's Hospital
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