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Jane and John Justin Neurosciences Center

When a medical condition interrupts your child's life, it can be scary, especially when it's related to the brain and nervous system. If your child is diagnosed with a neurological disorder or disease, it may ease your mind to know that our neurosciences department is one of the largest and most respected in the southwest.

In 2008, Cook Children's became the first free standing pediatric hospital in the U.S. and the only children's hospital in North Texas to offer a comprehensive movement disorder program that includes deep brain stimulation (DBS).

In May 2013, Cook Children's became the first children's hospital in North Texas and surrounding states to perform minimally invasive laser ablation brain surgery for children with intractable epilepsy and small brain tumors.

In September 2014, Cook Children's became the first free standing children's hospital in the country to acquire medical robotic technology used for minimally invasive neurosurgical procedures.

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Movement Disorder program

At Cook Children's, we know it's about more than medical expertise and advanced technology. It's about working together to tackle even the most complex condition.

That is why the Cook Children's Comprehensive Cerebral Palsy and Movement Disorders program offers a full range of diagnostic and therapeutic interventions based on a patient-centered, interdisciplinary team approach. Our movement disorders and neuromuscular clinics have dedicated teams of professionals, including physicians, nurse practitioners, physician assistants, physical therapists, occupational therapists, speech therapists, orthotics and prosthetics technicians, a clinical nurse specialist, a patient liaison, a social worker, bio-behavioral therapists, Child Life specialists and therapy dogs. The team works to meet the specific needs of each individual child and family, by developing comprehensive treatment plans that will enhance movement and empower lives.

Cook Children's Comprehensive Cerebral Palsy and Movement Disorders program serves approximately 2,900 children each year and offers:

Cook Children's is a Muscular Dystrophy Association-sponsored neuromuscular clinic and is active in clinical research to enhance the lives of people affected by movement disorders.

What is DBS?

Cook Children's is the first independent pediatric hospital in the United States, and the only children's hospital in North Texas, to offer a comprehensive movement disorder program that includes deep brain stimulation (DBS).

DBS is a surgical procedure involving the placement of electrodes into the brain that are connected to an implanted medical device, sometimes referred to as a brain pacemaker. The electrodes deliver continuous low-voltage electrical impulses to the targeted part of the brain. These pulses block the abnormal firing of neurons in the targeted area providing relief for patients whose symptoms are not properly controlled by medication. Goals of DBS surgery are to reduce muscle tone, improve function and prevent the progression of movement disorders from spreading throughout other areas of the body.

Successful DBS surgery can make significant improvements to a patient's quality of life, although those changes may occur three to six months after activation of the system.

At Cook Children's, DBS surgery has been performed on patients with Parkinsonian syndromes and dystonia, and, in the future, may be performed to help with other neurological disorders.

In December 2015, Cook Children's celebrated its 100th DBS surgery, further cementing its global leadership role as an international center of excellence for pediatric DBS surgery. The deep brain stimulation program was launched in 2007 and is performed on children struggling with dystonia, a group of severe movement disorders. Its goals are to reduce muscle tone, improve function and prevent the progression of movement disorders to other areas of the body. To date, Cook Children's Jane and John Justin Neurosciences Center has completed more than 100 DBS surgeries.

How does DBS work?

What is SDR?

SDR is a surgery performed on the spinal cord in the lower back of children with cerebral palsy or spasticity in the legs. There are two kinds of nerve rootlets in the spine – dorsal rootlets and ventral rootlets. The dorsal roots are ones that carry signals from the child's legs to the spinal cord and then to the brain. These are the roots that usually have abnormal communication between the muscle and the brain, therefore allowing spasticity in the muscle. In the surgery, very specific dorsal rootlets are cut to reduce spasticity, while preserving the child's ability to move.

Most candidates for SDR are able to walk, with or without the use of an assistive device, and have relatively good leg strength and muscle control. However, there are some cases in which surgery is performed on non-ambulatory children in order to improve their care. Ultimate candidacy is determined by our team of doctors and clinicians, but it's usually performed on children between the ages of 2-10 years who have a diagnosis of cerebral palsy causing increased spasticity, or stiffness, in their legs. Children will be evaluated by a team of specialists at Cook Children's Cerebral Palsy and Movement Disorders Center and in our motion analysis lab. During these visits, we will review your child's diagnosis, medical history and imaging and assess his/her tone, strength, range of motion, walking pattern and cognition. These pieces will help determine their appropriateness for the surgery.

Epilepsy Program

For patients who have failed two appropriate and adequately dosed medications for epilepsy, the chances of becoming seizure-free on a third medication or combinations of medications are less than three percent. More than a quarter of patients become "medically intractable" to treatment and should be evaluated for other treatment options to control seizures.

Cook Children's Comprehensive Epilepsy Program provides the highest level of care recognized by the National Association of Epilepsy Centers. We also provide the most advanced and accurate imaging with the magnetoencephalography (MEG) and the iMRI. It takes less than two weeks to evaluate patients in the program and results are presented at our weekly case conferences. Our neurosurgeons also consult neurologists in the operating room for the best possible patient outcomes.

Our epileptologists provide thorough testing and evaluation to help answer why a patient has epilepsy, what the patient can expect for the future and what treatments will provide the best seizure control and the best quality of life.

Diagnosis and treatment can involve many avenues, including:

Determining candidates for surgery:

For appropriate surgery candidates, multimodal imaging allows for localization of the seizure focus, as well as precise mapping of nearby language, motor, sensory or visual functions to avoid post-operative deficits. Imaging includes:

We offer:

Craniofacial and Cleft Surgery

Cook Children's craniofacial and cleft surgical team specializes in plastic and reconstructive surgery for children with face, head and neck conditions that they are born with, or may acquire later due to traumatic injury, disease or developmental disorders. Cook Children's Craniofacial and Cleft Surgery Program embraces a multidisciplinary team approach to craniofacial and cleft care, enlisting the talents of neurosciences, primary care physicians, pediatric and neonatal intensive care, anesthesiology, genetics, oral surgery, orthodontics, speech pathology, otolaryngology, ophthalmology, gastroenterology, pulmonology and radiology. The program works together with other specialties to care for the unique issues of each patient.

Cook Children's is a member of the International Society of Craniofacial Surgery and the American Society of Craniofacial Surgery.

Our team participates in national and international lectures on craniofacial and cleft surgery.

The Craniofacial and Cleft Surgery program received a physician-named Vitals Compassionate Doctor Award from the Vitals Awards & Recognition Program, 2014.

Conditions treated:

Abnormalities of the skull:

Abnormalities of the orbits and midface:

Abnormalities of the jaws:

Ear deformities:

Tumors:

Vascular lesions:

Named syndromes:

Rehabilitation Care Unit

Following surgery for SDR, patients will be transferred to Cook Children's Rehabilitation Care Unit (RCU). Cook Children's RCU also serves children and teens with head injuries and neurological illnesses. In the RCU, patients receive treatment from medical staff members from a variety of specialties and departments. Our inpatient pediatric rehab program combines medical and nursing care with individualized therapies, including education, support and discharge planning. This enables our team to focus on providing the best care for each child based on their particular diagnosis, while working alongside each family to create a plan of care that fits their unique needs. The overall goal of the RCU is to help patients reach their highest level of function following an injury or illness and return them to their homes as soon as possible.

Neurological rehabilitation

The RCU helps children recover from neurological problems caused by:

Cook Children's RCU features the latest rehabilitation technology, including:

Neurosurgery Team

John Honeycutt, M.D. – Medical Director, Neurosurgery
Medical Director, Neuro-Trauma
Co-Director of the Jane and John Justin Neurosciences Center at Cook Children's

Specialties: Neurosurgery

Education: University of Arkansas Medical Center, Little Rock, Ark.
Residency: University of Oklahoma, Oklahoma City, Okla.
Fellowship: University of Tennessee, Knoxville, Tenn.

Dr. Honeycutt is one of the lead physicians of the neurosurgery program at Cook Children's. Aside from his work as a neurosurgeon, he is frequently consulted and asked his expert opinion on difficult cases.

   

Daniel Hansen, M.D. – Neurosurgeon
Specialties: Neurosurgery

Education: University of Kansas School of Medicine, Kansas City, Kan. and Wichita, Kan.
Residency: University of Iowa Hospitals and Clinics, Iowa City, Iowa
Fellowship: Baylor College of Medicine, Texas Children's Hospital, Houston, Texas

   

Richard Roberts, M.D. – Neurosurgeon
Specialties: Neurosurgery

Education: Louisiana State University Medical School, New Orleans, La.
Residency: Children's Hospital, New Orleans, La. (Pedi Neurosurgery)
Fellowship: Children's Hospital of Philadelphia, Philadelphia, Pa.

   

David Donahue, M.D. – Neurosurgeon
Specialties: Neurosurgery

Education: University of Tennessee College of Medicine, Memphis, Tenn.
Residency: Baptist Memorial Hospital, Memphis, Tenn.; University of Tennessee, Memphis, Tenn.; Children's Memorial Hospital, Chicago, Ill.
Fellowship: University of Tennessee, Semmes-Murphey Clinic, St. Jude Children's; Le Bonheur Children's Hospital, Memphis, Tenn.

Awards/Recognition: Living Magazine: Best Doctors in America List 2015-2016, Super Doctors® Texas 2015

Neurosciences Team

Scott Perry, M.D. – Medical Director, Neurology
Co-Director of the Jane and John Justin Neurosciences Center
Medical Director, Tuberous Sclerosis Complex Clinic

Specialties: Neurology

Education: University of Mississippi School of Medicine, Jackson, Miss.
Residency: Emory University School of Medicine, Atlanta, Ga.
Fellowship: Miami Children's Hospital, Miami, Fla.

Dr. Perry's clinical and research interests focus on the treatment of childhood onset epilepsy, specifically those patients with uncontrolled epilepsy or those for which the cause has not been determined.

   

Warren Marks, M.D. – Medical Director, Movement Disorder and Neurorehabilitation Program
Specialties: Neurology, Rehabilitation

Education: Texas Tech University School of Medicine, Lubbock, Texas
Awards/Recognition: Super Doctors® Texas 2015
Residency: University of Oklahoma College of Medicine, Oklahoma City, Okla.
Fellowship: University of Oklahoma College of Medicine, Oklahoma City, Okla.

   

Cynthia Keator, M.D. – Medical Director, Epilepsy Monitoring Unit
Specialties: Neurology

Education: University of Texas Health Science Center, Houston, Texas
Residency: University of Colorado at Denver, Denver, Colo.
Fellowship: University of Colorado at Denver, Denver, Colo.

Dr. Keator has dedicated her career to the field of pediatric epilepsy, in part because there is always something new to learn, and especially because great strides are constantly being made in the medical treatments available to kids who are diagnosed with this condition.

   

Jeffery McGlothlin, M.D. – Neurologist
Specialties: Neurology, Neuro-Oncology

Education: University of Texas Southwestern Medical Center, Dallas, Texas
Residency: Baylor College of Medicine, Houston, Texas
Fellowship: Baylor College of Medicine, Houston, Texas

Awards/Recognition: Super Doctors® Texas 2015

Craniofacial, Cleft and Plastic Surgery Team

Eric Hubli, M.D., FACS, FAAP, FICS – Medical Director of Craniofacial, Cleft and Plastic Surgery
Specialties: Craniofacial Reconstruction

Education: Tufts School of Medicine, Boston, Mass.
Residency: Baystate Medical Center, Springfield, Mass.; Lahey Clinic Medical Center, Burlington, Mass.
Fellowship: Lahey Clinic Medical Center, Burlington, Mass.; International Craniofacial Institute, Dallas, Texas

Dr. Hubli brings 25 years of Craniofacial, Cleft and Pediatric Plastic Surgery experience to Fort Worth, Texas and the Cook Children's Healthcare System.

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Neurology consultations

Need help referring a patient?
Please call the International Patient Services department at +1-682-885-4685, send faxes to +1-682-885-2557, or email international@cookchildrens.org