Child neurology is a medical specialty dealing with brain, spinal cord, nerve and muscle diseases in children. It is also known as “Pediatric neurology” or “Developmental neurology”.
The diseases in question range from severe brain damage to temporary paralysis, from good or bad epilepsy to simple fainting, from autistic complaints to behavioral disorders, from muscle diseases to nerve injuries. It spreads over a wide range.
Examination and Clinical Evaluation
The first step to be taken in addressing patients' disorders is clinical evaluation. First of all, the course and story of the disease is heard firsthand and from the children's relatives, and then the child is examined. These first clinical impressions generally reveal information that leads to diagnosis for many diseases.
Although some advanced tests (such as MRI and EEG) always come to mind when addressing the neurological problems of patients, clinical evaluation has a very decisive role. From time to time, some misleading results obtained from patients' tests are rendered unimportant by simple clinical findings regarding the patient's illness.
Clinical Evaluation Issues in Child Neurology
The brain and Disorders related to the nervous system are very diverse. Among these, the important applications that we try to help under office conditions are as follows:
Age-appropriate neurological development problems:
- Delay in walking
- Hypotonic babies (SMA)
- Speech delay
- Autistic complaints
- Learning and school problems (attention problems)
Situations that occur as changes in consciousness or recurrent attacks:
- Febrile seizures
- Epileptic seizures
- Fainting
- Do not participate
- Headache
Problems that develop during labor or pregnancy:
- Difficult Brain damage due to birth (Cerebral palsy (CP), spastic or hypotonic paralysis)
- Damage due to premature birth (Spastic diparesis, tetraparesis)
- Damage to arm nerves at birth (Brachial plexopathy)
- Microcephaly (Small head size)
- Muscle diseases (Duchenne Muscular Dystrophy)
- Nerve involvement (Guillain Barré Syndrome, Charcot Marrie Tooth Syndromes)
- Ataxias
Conditions detected by imaging (MRI, CT, US):
- Hydrocephalus (water accumulation in the brain)
- Cysts in the brain (Arachnoid cyst)
- Brain tumors
- Brain hemorrhage, vascular tangles and enlargements (AVM, aneurysm)
- Spinal cord congenital anomalies (Spina bifida)
Movement disorders
- Tics (simple tics or Tourette Syndrome)
- Dystonias (uncontrollable irregular contractions)
- Chore-athetosis (involuntary rapid or twisting movements)
Behavioral disorders:
Although these are mostly psychiatric issues, they can be seen as additional problems.
- Hyperactivity/attention deficit
- Social adaptation problems
- Obsession
Genetic or metabolic problems:
- Thyroid gland problems
- Amino acid metabolism disorders (Phenylketonuria)
- Organic acid metabolism problems
- Mitochondrial diseases
- Chromosomal anomalies (Down Syndrome)
- Genetic conditions manifested by facial and other structural differences
Features Evaluated in Child Neurology Examination:
- General condition, age-appropriate response and development
- Orientation and knowledge status
- Head size
- Speech and movement skills
- Coordination, reaching and balance
- Strength, walking ability
- Reflexes
- Pathological and neonatal reflexes
- Visual and hearing fields
- Eye movements and fundus
Some of these evaluations may provide suspicious and insufficient information, depending on age. The general clinical picture and history are again very decisive. The importance of additional tests usually becomes apparent after these.
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