History and Examination of a Baby Flashcards
What should particular attention be paid to in neurological history taking?
- Age of onset
- Developmental history, including age of milestones and loss of any skills
- Deterioration in school performance
- Detailed family history
- Impact of the problem on family life and functioning
What categories do neurological presentations typically fall into?
- Developmental delay
- Developmental regression
- Weakness
- Abnormal movements
- Change in level of consciousness
- Paroxysmal events
- Headache
- Traumatic injury
Give an example of a condition causing developmental regression?
Rett’s syndrome
Give an example of a condition causing weakness?
Muscular dystrophy
Give an example of a type of abnormal movement
Ataxia
Give an example of a condition causing a change in level of consciousness
Encephalopathy
Give an example of a condition causing paroxysmal events?
Epilepsy
Give an example of a condition causing headache?
Migraine
When is a full neurological examination required?
When a neurological disorder is suspected
In what positions should a baby be examined?
- Supine
- Sitting
- Standing
- Prone suspension
What should be looked for on examination when the baby is supine?
- General movements, posture, and alertness
- Birthmarks
- Measure and plot head circumference
- Assess fontanelles and head shape
- Lift head and do Moro reflex if necessary
- Individually assess tone, power, movement, and reflexes in each limb
- Observe response to sound
- Assess pupil responses, reaction to light, object fixation, and red reflexes/fundoscopy
- Take both hands
- Pull baby by hands to siting
Why is it important to check for birthmarks?
To look for neurocutaneous markers
Why is it important to assess fontanelles?
To look for hydrocephalus
Why is it important to assess head shape?
To look for craniosynotosis
How do you elicit the Moro reflex?
Allow head to fall back quickly supported in your hand by a short distance, and assess reaction of arms
