Attention Deficit Hyperactivity Disorder: Minimal Brain Dysfunction - ADHD

Written by Dr. W.J. Levin

If one recalls that the basic elements in the embryo which develop into brain come from Ectoderm, and that all skin and superficial structures also develop from Ectoderm, then any unusual cerebral development certainly could be accompanied by mild skin and superficial deviations. These unusual features could not be caused by emotions and the behavior patterns likewise are not caused by emotions, but by neurological variations.

Some time ago, in the "British Practitioner" a comment was made that there are no emotional conditions, but only emotional reactions to neurological conditions. The emotional reactions of A.D.H.D. children, whether they have a hyperactive behavior problem, a hypoactive learning problem, or a mixed type are most likely secondary to the neurological disability. The family history also suggests a genetic etiology.

Some research has shown that in some cases an irregular and unusual cellular arrangement exists on the left side of the brain as seen under a microscope. Electroencephalograms can sometimes show immature or asymmetrical brain waves but this is not diagnostic. Chromosomal studies have also been used to suggest the genetic origin as a possible causative factor.

From a biological point of view, early, yet suggestive evidence is available to suggest that a biochemical defect does exist in many children with learning disabilities in the form of a neuro-transmitter deficiency. This explains why replacing these deficient neuro-transmitters with psychostimulant medication can in some cases bring about such vast improvements so rapidly.

One cannot survive without water, a natural body requirement, never the less the drinking thereof is not an addiction. Medicating with psychostimulants is not unlike replacement therapy in a diabetic or thyroid deficient patient. Replacement therapy cannot therefore be labeled "drugging". That there are no addicts to Ritalin is therefore not surprising.

The pioneering work of the American neuro-surgeon, Roger Sperry, on the split brain, over the last few years has shed much light on the left and right hemisphere brain function and helped to dispel many old beliefs and theories. Perhaps now that Dr. Sperry has been honored by the medical fraternity for his research by bestowing on him the highly sought after Nobel Prize for medicine (1981), older psychological ideas will die gradually and make for new concepts in neuro-psychology. This would hopefully allow anxious and doubting teachers to accept the idea that the brain (while still in the head) they teach at school, is still part of the human body and the doctor's domain.

Therefore, the basic physiology, pathology, diagnosis and treatment also remain medical. The teacher does in fact become part of a new para-medical team in co-operation with speech therapists and remedial therapists. Psychotherapy is seldom required, but when necessary, essential.

The final comment must be that if the medical practitioner hopes to be elected as the co-ordinator of the diagnostic and therapeutic team, he must prove his worth by acquiring the new knowledge that is available today."

About the author: Dr. Billy Levin (MB.ChB) has spent the last 28 years treating patients with ADHD. He has researched, developed and modified a diagnostic rating scale of which he has evaluated over 250 000 in about 14 000 case studies. He has been a speaker at several national and international symposiums and has had articles published in various teaching, medical and educational journals and on the Internet. He has written a chapter in a textbook (Pharmacotherapy edited by Prof. .C.P. Venter) and received nominations by his local branch of SAMA for a National award (Excelsior award) on two occasions."

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