Physical and Neurologic Examinations

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Detailed physical and neurologic examinations should be performed in every child presenting with a possible seizure and should include measurement of the child’s head circumference, cardiac examination, abdominal examination assessing for organomegaly, and a dermatologic examination using a Woods lamp (to look for signs of neurocutaneous syndromes).

In active infants and toddlers, most of the neurologic examination is often based on observation—does the child use both hands equally when playing with a toy, is there tremor or dysmetria when reaching out for a book, does the child have any gait abnormalities, etc. The examiner should pay attention to symmetry—are there differences in strength or reflexes on one side of the body compared with the other side. By modifying the neurologic examination based on the age and cognitive ability of the patient, most physical features can be assessed.

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