Pediatric Neurologist – Sleep Medicine Specialist
Dr. Ioanna Kouri was born in Athens and graduated from the Medical School of Ioannina as valedictorian. She completed the specialty of Pediatrics at the “Agia Sofia” Children’s Hospital. Subsequently, she obtained an ECFMG certificate (Certificate from Educational Commission for Foreign Medical Graduates), which is necessary to enroll in postgraduate training in the United States of America.
Dr. Kouri obtained the specialty of Pediatric Neurology at the University of Iowa, IA, U.S.A., and the specialty of Sleep Medicine at the Mayo Clinic, Rochester, Minnesota, U.S.A.
She is an attending physician at Mitera, Metropolitan, and Leto Maternity Hospital in Greece. At the same time, she is a Research Associate at the Mayo Clinic in the U.S.A.
Dr. Kouri is a diplomate of the American Board of Psychiatry and Neurology with Special Qualification in Child Neurology and the American Board of Sleep Medicine. She holds a license to practice in the U.S.A and Greece and is an active member of many scientific associations. Her research focuses on pediatric stroke, neuromuscular diseases, and sleep apnea of central etiology. She has many presentations at international conferences and publications in international medical journals.
Services
physical examination
The clinic offers a complete neurological examination of the child, strictly adapted to its age and the related pathology. The physical examination evaluates objective anatomical findings through observation, palpation, percussion, and auscultation. Parents are kindly requested to provide the child’s health booklet and all laboratory and imaging tests done until the evaluation in the clinic.
electroencephalogram
The electroencephalogram is an examination that records the brain’s electrical activity with the help of special cables (electrodes), which are placed on various parts of the surface of the skull’s skin. The electrodes are then connected to a unique instrument, the electroencephalograph. In this way, the electroencephalogram monitors the state of consciousness of the examinee: the voltage oscillations tell a limited yet essential part of the history of brain function. In other words, the electroencephalogram is a window into the human mind!
sleep study
Sleep is a complex biological process. While we sleep, we are seemingly unconscious, but our brain and body are still active. Our brain and body perform many vital functions that help us stay healthy. So not having enough quality sleep does not just mean we feel tired. It can be detrimental to our physical and mental health, cognition, and normal daily functioning. There are more than 80 different disorders, and – as in all nosologic entities, it is essential to identify the specific cause of each patient’s condition accurately.
Pediatric Neurology
What is Pediatric Neurology
The medical specialty of pediatric neurology is the study of disorders of the brain, spinal cord, nerves, and muscles that affect infants, children, and adolescents.
If there are concerns related to the child’s nervous system, a pediatric neurologist has the specialized training and knowledge to evaluate, diagnose and treat any underlying conditions.
The variety of patients taken care of by the pediatric neurologist is broad. It includes those with common, relatively simple conditions, such as migraine, and those with rare or complex conditions, such as metabolic or neurodegenerative disorders.
Common pediatric neurology disorders:
- Developmental delay
- Birth defects affecting the nervous system
- Traumatic brain injury
- Cerebral palsy
- Epilepsy
- Dizziness, vertigo, instability
- Metabolic diseases affecting the nervous system
- Neuromuscular diseases, including muscular dystrophies
- Brain tumors
- Headaches, such as migraine, tension headache and after concussion
- Behavioral disorders such as tics, Tourette syndrome
Diagnostic tests
The electroencephalogram is an examination that records the brain’s electrical activity with the help of special cables (electrodes), which are placed on various parts of the surface of the skin of the skull and then connected to a unique device, the electroencephalograph. The electrodes detect very weak electrical charges resulting from nerve cells’ activity during the examination, which is recorded as a waveform on the computer screen and interpreted by the specialized doctor. The examination serves to diagnose and monitor patients with conditions such as epilepsy and find the cause of an episode of alteration or loss of consciousness. It is a painless and safe examination. Electrodes record the brain’s electrical activity without being felt by the examinee. The examinee should not eat at least 2 hours before the examination and should wash his/her hair the same day. The placement of the electrodes takes about 20 minutes, and the examination lasts 1 hour or more, depending on the indication. We may ask the examinee to take deep breaths for a few minutes or present intermittent light stimuli. The simultaneous video recording is necessary to correlate the episodes in question with the brain waveforms recorded. If there is evidence of an underlying epileptic disease, we would likely suggest a prolonged sleep-deprived electroencephalogram.
Sleep Medicine
What is Sleep Medicine
The sleep doctor is the specialized doctor who treats children who have trouble sleeping. Sleep disorders are common, occurring in about 20% of children. Sleep disorders have negative consequences on physical and mental health, cognition, academic performance, behavior, quality of life of the young patient, and ultimately, the whole family. Proper and timely diagnosis is essential because it enhances the effectiveness of the treatments available for each case.
The variety of sleep disorders is quite wide. It includes symptoms that range from the mildest, such as periodic insomnia, and extend to problems of normal breathing, intense activity during sleep, difficulty staying asleep, and excessive drowsiness during the day. The specialized doctor will begin by carefully examining the child’s health history, emphasizing the sleep history, and carrying out a thorough examination. The diagnosis may require a very specialized examination called a sleep study in some cases. The examination is offered at home or in specialized centers as clinically determined.
Common sleep problems:
- Insomnia
- Sleep disordered breathing
- Circadian rhythm disorders
- Sleep related movement disorders such as Restless legs syndrome
- Parasomnias (sleep terrors, sleep walking, confusional arousals)
- Jet lag
- Central disorders of Hypersomnolence such as Narcolepsy
Diagnostic Tests
The sleep study is an examination that records the brain activity and the respiratory function of the examinee during sleep. It helps diagnose sleep disorders such as sleep apnea, periodic limb movements, narcolepsy, insomnia, and nocturnal behaviors such as REM sleep behavior disorder. Often these conditions cannot be identified with a regular visit to the clinic, and the doctor should gather more data during sleep.
While the child is sleeping, electroencephalographic electrodes monitor the sleep stages so that the physician can identify possible disturbances in the sleep architecture. The sleep study also records other signals such as eye movements, oxygen levels in the blood (through a sensor – no needles are involved), heart and breathing rhythms, snoring, and body movements.
The sleep study is done in a room that is comfortable and dark. You can bring personal items related to sleep (a favorite pillow, blanket or fluffy animal, book), and the child can sleep in his pajamas. The sleep technologist will place special wires (electrodes) on various parts of the skin of the skull and body, but he/she will still have enough space to move and feel comfortable. The sleep technologist monitors the study in real-time during the night.
When necessary, the examination is completed with an examination the following day (multiple sleep latency tests).
Affiliations
Dr Kouri is affiliated with Mitera, Lito, Metropolitan Hospitals
and is a research collaborator at Mayo Clinic in Rochester, MN.
Testimonials
Gallery
Contact
Address:
18 Kifisias Ave., Ampelokipoi,
Athens, 115 26
Telephone:
+30 211 118 6686
+30 694 288 4798
Email:
ikouri@pedoneurology.gr