PPC SERIES Approach to Neurological Symptom Management in Children at the End of Life

Many children in hospice have neurological symptoms at the end of life, whether their underlying disorder is primarily neurologic or as a late complication of a malignancy or other medical issue. We will review common causes of neurologic symptoms, including agitation or irritability, seizures, and tone abnormalities. We will discuss approaches to management of these symptoms, including non-pharmacologic and pharmacologic treatments that can be achieved in the home or hospice setting.

Objectives:
1. Identify risk factors for seizures at the end of life
2. Understand the natural course of a prolonged procedure at home, and approaches to comfort measures
3. Identify risk factors for neurological-irritability and approaches to treatment
4. Recognize the ways that hypertonia or movement abnormalities can cause discomfort, and understand pharmacologic and nonpharmacologic approaches

About the presenter: Dr. Audrey Foster-Barber

Dr. Audrey Foster-Barber is Associate Professor of Neurology at UCSF. She is an expert in pediatric neurology who has a special interest in treating problems related to seizure, pain, movement disorder and neurogenetic disorders. She is outpatient director of the Pediatric Brain Center at the Benioff Children’s Hospital, San Francisco, Program Director for the Child Neurology Residency at UCSF, and Vice Chair of Education for the Department of Neurology. She is additionally board certified in Hospice and Palliative Medicine, and works with the pediatric hospice team at Hospice By the Bay. Foster-Barber graduated from Harvard College, where she earned an undergraduate degree in biology. At UCSF, she earned a medical degree and doctorate in biochemistry with an emphasis on neuroscience. She also completed a residency in pediatrics and child neurology at UCSF. She is the recipient of the UCSF Medical Center Exceptional Physician Award, several teaching awards, and the Child Neurology Society Gold Humanism Award for 2018. In her treatment of children with neurological disorders, she strives to maximize their quality of life and developmental potential while supporting patients and families on their journey wherever it takes them.