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Your Child

Botox for Children’s Migraine Headaches

2:30

If your child suffers from migraines, Botox may be able to help. Typically thought of as a beauty enhancement, Botox has also become an effective treatment for people that experience 15 or more migraine attacks each month.

Botox is a form of a toxin that temporarily freezes the muscles. It helps to prevent migraines by blocking muscle spasms.

Since Botox has been approved for treating adults with migraines, researchers from the University of California, Irvine, wanted to know if Botox would also work for children and adolescents.

The study included nine children and adolescents between ages 8 and 17 years of age. Over a period of five years, the participants received treatments every 12 weeks, and saw significant decreases in the frequency and severity of their headaches. The Botox had no major side effects.

Initially, the children and teens reported their pain levels during migraines as being between four and eight, on average. After Botox injections, these levels fell to a rant of 1.75 to five. Originally, they had experienced migraines anywhere from eight to nearly 30 days of each month, but after Botox, the patients got between two and 10 monthly migraines.

The study noted that many adults that have migraines began having them as children. By the time they receive the Botox treatments, they’ve been suffering for many years.

Dr Shalini Shah, one of the study’s co-authors told Daily Mail Online that management of children’s migraines mostly comes down to trial and error.
Typical treatment for children with migraines includes over the counter or prescription Tylenol or Advil.  If those drugs don’t help, a child might be prescribed a seizure medication, which Shah says children don’t tolerate well.

Shah has been using Botox off-label to treat migraines in her pediatric patients for years.

‘Most of the kids I get [as patients] are being home-schooled,’ she says. Their migraines are so debilitating, and, in many cases last multiple days, that they are not able to attend regular school and keep up with assignments.

What’s worse, she says, is that other treatments - like Advil, Tylenol or seizure medications – are sedatives that can make children drowsy and nauseous.

The treatments for migraines themselves leave children ‘half-asleep, and that’s no way to really live,’ she says. Both migraines and their medications cause children to struggle in school.

To treat migraines, Botox is injected at several sites at the front, back and sides of the head and in the neck, in both adults and children.

 Shah says that Botox has been used to treat many other forms of head pain in children, including headaches with other causes, like cancer. But the FDA hasn’t approved its use for migraines simply because ‘it’s never been systematically studied,’ she says.

Shah recommends that parents who are considering taking their child for Botox treatment make sure that they find a physician with plenty of experience.

While side effects may be low, Botox is not risk-free.

The primary risk with Botox is that the toxin could travel to other parts of the body. Even locally, if it traveled just slightly from the injection site, clinicians have to worry that it could paralyze muscles used in breathing or freeze the neck in an odd or uncomfortable position.
So far, the study authors have not observed these or other longer-term effects after giving more than 1,000 injections, Shah said.

There is no way to completely prevent the chemical from traveling, but someone experienced giving Botox injections is the best way to reduce risks.

Shah says that these results ‘demonstrate promise’ to finally provide more than a trial and error approach to preventing and treating migraines in children and teens, but she says that the forthcoming, larger trial is needed to prove that Botox is safe and effective for a younger demographic.
The study’s results were presented at the American Society of Anesthesiologists’ Anesthesiology 2017 annual meeting in Boston, Massachusetts.  The research team noted that about 60 percent of visits to pediatric headache specialists are for migraines.

Story source: Natalie Rahhal, http://www.dailymail.co.uk/health/article-5009487/Botox-help-prevent-migraines-children-teens.html#ixzz56NhzVLuK 
 

Parenting

Virtual Reality Headsets and Kids

3:30

Virtual reality (VR) headsets are on a lot of people’s gift lists this year, but are they safe for children?  Before a child receives one of these shiny new objects, parents really should take a serious look at the pros and cons of this modern day technology.

Virtual reality is an artificial environment that is created with software. It primarily affects two of the five senses: sight and sound. Head mounted displays can be used with headphones and hand controllers to provide a fully immersive experience.  Total immersion means the sensory experience feels so real that one can forget they are experiencing an artificial reality and begin to interact with the technology, as if it is a real world experience.

The software has become so good in some cases that people, particularly children, can’t tell where fantasy begins and real world life ends.

Is virtually reality a safe experience for children? It depends on several factors such as time spent on the device, content and supervision.

Medical research on VR and young or very young children is practically non-existent. Most of the studies apply to teens and young adults with very few focused on children younger than 12.

There are however, several major health concerns parents should consider. The first is how VR can affect the eyes.

"There are a variety of potential issues," said University of California, Berkeley optometry Professor Martin Banks, who studies visual perception in virtual environments "One is how we affect the growth of the eye, which can lead to myopia or nearsightedness." 

Myopia is a growing problem around the world. In the United States, studies show, nearsightedness rose from only 25% of the population in the 1970s to over 40% by 2000. About 10 million American adults are considered "severely nearsighted."

"Looking at tablets, phones and the like, there's pretty good evidence that doing near work can cause lengthening of the eye and increase risk for myopia," Banks said. "We're all worried that virtual reality might make things worse."

"In a virtual environment, the way we look and interact is changed because we may be projecting onto the eyes something that looks far away, but in reality, it's only a few centimeters from the eye," said Walter Greenleaf, a behavioral neuroscientist who has studied VR in medical settings for over 30 years.

Science calls that the "vergence-accommodation conflict" and isn't quite sure how serious it might be. "We're tricking the brain," said Greenleaf, who works with Stanford University's Virtual Human Interaction Lab, "and we don't know the long-term effect of this."

Another concern is hearing loss. Listening to sound at a high volume can damage your hearing, creating possible long-term effects with hearing loss.

It's not just the eyes that might be harmed. "Listening to sound at high volumes can cause irreparable damage to your hearing," states Oculus Rift’s website, a VR headset developed and manufactured by Oculus. Loud sounds are a known contributor to hearing loss. Volume on a headset should not be set so high that the person wearing the headset cannot hear someone talking to them.

Pre-existent health conditions may also be a concern.

Some of VR headset manufacturers issue warnings to potential users about conditions such as epilepsy, implanted medical devices, abnormal vision or psychiatric disorders and balance problems. Falling or tripping over objects seems to be a somewhat common occurrence.

"While wearing the product's headset you are blind to the world around you," says the safety information page for HTC's Vive, "Do not rely on the product's chaperone system for protection."

"I see more falling than anything else," said Marientina Gotsis, an associate professor of research at the Interactive Media and Games Division of the University of Southern California. "You can trip and hit your head or break a limb and get seriously hurt, so someone needs to watch over you when you are using VR. That's mandatory."

Gotis believes that younger children should be especially cautious with virtual reality.  If they try it, Gotis adds, the younger the child, the shorter the exposure should be. A child should always be monitored for safety.

VR content can feel so genuine that it may actually affect your child’s perception of reality.

"VR can be stored in the brain's memory center in ways that are strikingly similar to real-world physical experiences," said Stanford's Bailenson, author of the forthcoming book "Experience on Demand," about his two decades of research on the psychological effects of virtual reality. "When VR is done well, the brain believes it is real." 

That's great if the content is fun, educational or inspirational.

But what if the content is scary or combative? Some of today's popular VR games allow you to fight off bloody zombies, get a "virtual tour of hell," battle "endless waves of combatants" and kill as many as you can in "survival horror." In one game, you can even shoot yourself in the head. I’m pretty sure most parents wouldn’t want their child- no matter what age- to contemplate or experience that kind of reality.

In a recent study by Jakki Bailey of the University of Texas, funded by the nonprofit Sesame Workshop, 55 children between the ages of 4 and 6 played the game Simon Says with the furry blue monster Grover, a popular character. Half of the children played in virtual reality; the other half played with Grover's character on a TV. The games lasted five minutes.

The good news, says Bailenson, is that none of the children in the VR experience became dizzy or had unpleasant physical reactions to their short exposure. 

"But the children who saw Grover in VR saw him as more real," he said. "Grover was more influential in immersive VR than on TV, and it was harder for the children to inhibit their actions and not do what Grover did." 

It's not just little ones that might internalize a VR scenario. Older adolescents were also found to be painfully sensitive to being socially excluded in a virtual environment.

This means parents need to be careful about the type of VR content they allow their children to view, experts say. Experts urge parents to actually watch any content or game in its’ entirety, that they are thinking about giving their child.

While VR isn’t a brand new technology, how people experience it is changing rapidly. It can be an amusing journey for short periods, or one can get lost in its artificial stimulation and disengage in communication and experiences with real people. This is new territory for many parents and children. Many of the VR headset manufactures and software suppliers recommend that the headsets be used by only ages 12 and up.

Researchers may see the need for future studies involving younger children and VR as this type of technology increases in popularity. Perhaps it might be better to wait awhile before letting your little ones immerse themselves in this “new” reality.

Story sources: Sandee LaMottee, CNN, http://www.cnn.com/2017/12/13/health/virtual-reality-vr-dangers-safety/index.html

http://www.realitytechnologies.com/virtual-reality

 

Your Child

City Kids With Asthma Do Better Living Near a Park

2:00

The beauty of tall trees, open space and rows of lush flowers may not only offer a respite from cramped city living, but might reduce asthma symptoms in children as well, according to a new study.

An interesting, albeit small, study of urban children in Baltimore, Maryland, showed that the closer a child with asthma lived to a park or green space, the fewer symptoms they displayed compared to children with asthma that did not live near a park.

The new study included 196 inner-city children in Baltimore, aged 3 to 12 years, with persistent asthma. Some lived close to a park or other green space, while others were more than 0.6 miles away from one.

Researchers found that the farther the children lived from a park, the more asthma symptoms they experienced over a two-week period. For every 1,000 feet between their home and a park, children had symptoms one extra day.

"Living in a city environment increases the risk of childhood asthma, and factors associated with city-living -- such as air pollution -- are also known to contribute to high rates of poorly controlled asthma," study author Kelli DePriest said in a society news release.

Other studies have suggested that children with asthma benefit from exercise, and the presence of green spaces promotes physical activity and helps lower pollution, she said.

Children that were 6 years old or older benefited the most from being in the park.

DePriest said that's probably because they are freer to roam than younger kids.

DePriest suggested city planners should consider the health benefits of adding more parks to children’s environments.

In addition to policymakers and city planners, healthcare providers could also provide more information to parents and caregivers about the advantages of taking their children to parks and green spaces.

The study findings "will also help health care providers to take a more holistic view of their patients by understanding how access to green space might affect health," she concluded.

The study will be presented to a European Respiratory Society in Milan, Italy. Researched presented at meetings are typically considered preliminary until published in a peer-reviewed journal.

Story source: Robert Preidt, https://consumer.healthday.com/respiratory-and-allergy-information-2/asthma-news-47/for-city-kids-with-asthma-nearby-green-space-is-key-726293.html

 

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