Infant Neurological Examination Research Articles

Neonatal and Infant Neurological Examination: Value and Applicability in Recent Medical Setting in Vietnam.

Neonatal and Infant Neurological Examination: Value and Applicability in Recent Medical Setting in Vietnam.

The Key Aspects of Neonatal and Infant Neurological Examination: The Ballard Score, the Infant's Head with Hydrocephalus and Assessment in a Clinical Setting.

The physical examination of the newborn is essential in diagnosing neurological or neurosurgical conditions in the newborn. This article focuses on three clinical assessments of newborns and infants that are especially important if neurological problems are suspected: The Ballard score, the examination of the head in a baby with (suspected) hydrocephalus, and the neurological and developmental evaluation of an infant in an ambulatory setting. A textual description and a link to a video describe each assessment.

Principles and Practice of Child Neurology in Infancy, Second Edition Edited by Colin, KennedyLondon: Mac Keith Press, 2020. £65.00 (Softback), pp 552. ISBN: 9781911612001

The first edition of this practical guide was published in 2012 and became the basis of a teaching series for the European Pediatric Neurology Society. Principles and Practice of Child Neurology in Infancy may not have seeped into the consciousness of North America yet, but that is likely to change with the second edition. It is a thoughtfully constructed title and fills an important niche in pediatric neurology. There are 29 multi-authored chapters organized into two main sections: the first being a general approach and the second devoted to clinical topics. The general approach section covers a wide breadth, including inter-professional working, evidence-based medicine, neonatal and infant neurological examinations, vaccination, imaging, neurophysiology, biochemical testing, genetic testing, drug treatments, and nonpharmacological approaches. The clinical topics begin with birth asphyxia and acute newborn infant encephalopathy, and then cover areas pertinent to neonates (vs infants). There is a neonatal seizure chapter and later a post-neonatal seizure chapter, as well as a separate discussion of non-epileptic paroxysmal disorders in infancy. There are individual chapters on microcephaly (including congenital infections) and macrocephaly (including hydrocephalus and brain tumors). Chapters more focused on the post-neonatal period include the hypotonic infant, infant sleep and behavior, cerebral palsy, movement disorders, and developmental regression. Each chapter begins with highlighted, boxed sections covering ‘Key messages’, ‘Common errors’, and ‘When to worry’, and ends with key references followed by resources. This consistent structure sets a user-friendly tone and provides immediacy to what the clinician (novice and seasoned) really needs to know. The first chapter, authored by Colin Kennedy (editor of the book), implores us to use terms with precision and exercise our responsibility to encourage standard care and discourage unproven, potentially harmful measures. The chapter on inter-professional care covers childhood (and parental) depression and living with a disability, so pertinent in this domain of pediatric medicine. Andrew Lux’s tour-de-force in epidemiology is essential reading for anyone writing, or reviewing, in the peer-reviewed literature. The chapter on promoting child development develops into a superb discussion of neurodiversity and the right to ‘live happily ever after’, drawing from sources such as the United Nations and the World Health Organization. The chapters on the neonatal examination, infant developmental and neurological evaluations, and vaccination/disease prevention are well done and deserve a wide audience of pediatricians and neurodevelopmental specialists. The discussions on classical diagnostic tests (imaging, electroencephalography, laboratory medicine) are lucid introductions with advanced information as well. The genetic testing portion is timely and paramount, and perhaps could even include the standard terminology of gene variants in a future rendition. The discussion on drug treatments has comprehensive and practical information on vitamin treatments in neonates. The chapter on nonpharmacological treatment – a topic often unseen in standard child neurology literature – is a balanced and welcome addition. The second section of the book, as noted above, covers the major clinical topics of neonatal/infantile neurology. Each chapter is rich in clinical detail plus some surprises, e.g. a primer on herniation syndromes in the chapter on acute neurological illness with fever. While there are some inconsistencies (e.g. references range from none to 30+), each chapter maintains the same organizational pattern of ‘Key messages’, ‘Common errors’, and ‘When to worry’. What could be better? Mac Keith Press, publisher of Principles and Practice of Child Neurology in Infancy, now also offers an online interactive course based on the volume’s contents. This carefully edited book, spanning the neonatal and infantile periods, is sure to enter the pantheon of authoritative works in pediatric neurology and become an educational treasure for the foreseeable future.

Neurologic Examination Findings Associated With Small Cerebellar Volumes After Prematurity

To help clinicians understand what to expect from small cerebellar volumes after prematurity, this study aims to characterize the specific impacts of small cerebellar volumes on the infant neurologic examination. A prospective cohort of preterm newborns (<32 weeks' gestational age) had brain magnetic resonance imaging (MRI) studies at term-equivalent age. Cerebellar volumes were compared with neurologic examination findings in follow-up, adjusting for severity of intraventricular hemorrhage, white matter injury, and cerebellar hemorrhage. Deformation-based analyses delineated regional morphometric differences in the cerebellum associated with these findings. Of 119 infants with MRI scans, 109 (92%) had follow-up at 19.0±1.7 months corrected age. Smaller cerebellar volume at term was associated with increased odds of truncal hypotonia, postural instability on standing, and patellar hyperreflexia (P < .03). Small cerebellar volume defined as <19 cm3 by 40 weeks was associated with 7.5-fold increased odds of truncal hypotonia (P < .001), 8.9-fold odds postural instability (P < .001), and 9.7-fold odds of patellar hyperreflexia (P < .001). Voxel-based deformation-based morphometry showed postural instability associated with paravermian regions. Small cerebellar volume is associated with specific abnormalities on neurologic examination by 18 months of age, including truncal tone, reflexes, and postural stability.

Neurological examination of the infant: A Comprehensive Review.

Clinicians are required to perform neurological examinations on infants to ensure they meet developmental milestones. A full neurological examination includes evaluating motor and sensory function, assessing the status of the cranial nerves, testing primitive reflexes, and atypical responses to further evaluate any developmental pathologies. The difficulty in maintaining infants' cooperation requires resourcefulness on the clinician's part to understand what is being tested and in what way to complete the examination. This literature will provide clinicians with guidance on the way to conduct a thorough neurological examination of infants. Clin. Anat. 32:770-777, 2019. © 2019 Wiley Periodicals, Inc.

Infants with vitamin B12 deficiency-related neurological dysfunction and the effect of maternal nutrition

Aim: Studies linked vitamin B12 deficiency in infancy are most commonly in patients with hematological and dermatological complaints rather than infant with neurodevelopmental retardation. In our study we aimed to evaluate the data of infants who presented with various neurological complaints and determined neurodevelopmental retardation due to vitamin B12 deficiency and also effects of maternal diet on the infants.Material and Methods: Infants who were admitted with various neurological complaints due to vitamin B12 deficiency between the dates of September 2016 and March 2018 were included in this study. Patients were retrospectively analyzed according to age, growth and development, clinical and laboratory findings (neurological, hematologic), continuation of breastfeeding, age at onset of complemantary food. During the pregnancy and lactation, the amount of feeding with animal foods, intake of vitamin supplements, duration of breastfeeding and vitamin B12 levels were examined.Results: The most common complaints were fatigue, pallor, no eye contact, apathy, vomiting, constipation, diarrhea, refusal to feed, retardation to growth and development, undeveloped or lost of ability (ability to tonic neck reflex, ability to sit supported and unsupported ability to sit). In the neurological examination of infants; iIn 13 infants, there was hypotonia, undeveloped ability to tonic neck reflex and ability to sit (supported and unsupported). Fifteen, in 15 infants just undeveloped ability to sit (supported and unsupported) and also in 6 infants had swallowing disorders.Conclusion: Vitamin B12 routinely to all pregnant women like folic acid and iron supplementation. In addition, developmental stages of infants should be evaluated and vitamin supplements should be given to infants when necessary.Keywords: Breastfeeding; Infant; Neurological Findings.

Evaluation of Artery Sequential Interventional Therapy on Pernicious Placenta Previa

Objective: To evaluate the effect of artery sequential interventional therapy (internal iliac artery catheterization and occlusion/ uterine artery or internal iliac artery embolization) on the hemorrhage of pernicious placenta previa. Method: The total of 29 patients with pernicious placenta previa and risk factor of placenta accreta from March 2012 to June 2013 in our hospital were included as control group, who were given traditional method of treatment, while 40 patients with the same disease status from July 2013 to October 2014 as treatment group with artery sequential interventional therapy. The amount of blood loss during operation and red blood cell suspension transfusion, the rate of hysterectomy cesarean time, the amount of cesarean section hemorrhage after 24 hours, duration of postopera tive hospital stay, the time of postoperative antibiotic usage and the prevalence of complications (pain, fever, infection and others) of patients in two groups were evaluated, respectively. Result: The significant difference of amount of blood loss during operation [(868.5±549.77) ml vs. (1506.90±1417.39) ml for treatment group and control group, respectively)] and red blood cell suspension transfusion [(1.50±1.40) U vs. (2.72±2.00) U], the rate of hysterectomy (2.50% vs. 17.24%), cesarean time [(58.86±20.33) min vs. (70.83±29.26) min)] and the prevalence of pain (81.25% vs. 48.28%) and other complications (0.00% vs. 10.35%) (all p values 0.05). All patients resumed normal menstruation after weaned for 1 to 3 month and the routine newborn physical examination on 42 days after birth, blood analysis, liver function and neurological examination of infants were normal without blood diseases. Conclusion: Artery sequential interventional therapy for patients with pernicious placenta previa was safe, effective and feasible for pregnant and newborn.

The relationship between the time from arrival at a hospital to delivery and the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age

Purpose : This study aimed to evaluate whether a shorter time from the arrival at a hospital to delivery is related to the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. Methods : We studied 142 newborns of less than 34 weeks of gestational age. The time from the arrival at the hospital to delivery was measured. The correlation between the time required for delivery and the occurrence of cerebral palsy was elucidated by diagnosing cerebral palsy in neonates using the Korean Infant Development Screening Test and neurological examination. Results : Preliminary result suggested that a shorter time from hospital arrival to delivery was related to a lower development score for gross motor activity and to a higher frequency of cerebral palsy occurrence. Moreover, it was responsible for a tendency of obtaining lower Apgar scores at 1 and 5 minutes. The shorter delivery time was associated with a higher probability of respiratory distress syndrome (RDS) occurrence when the length of delivery time was less than 6 hours and there was a higher probability of a shorter gestation period. However, the multifactor analysis revealed that there was little impact of delivery time on the occurrence of cerebral palsy. Conclusions : The length of hospital arrival time to delivery did not significantly influence the occurrence of cerebral palsy in premature infants of less than 34 weeks of gestational age. (Korean J Pediatr 2009;52:1228-1233)

Interrater Reliability in the Assessment of Muscle Tone of Infants and Children

The assessment of muscle tone is an integral part of the neurological examination of infants and children. Detection of an alteration in muscle tone aids in establishing a diagnosis, is used as justification for therapeutic services, and is viewed as an indicator of neurological change. The purpose of this study was to establish the degree of interrater reliability among pediatric physical therapists in the assessment of muscle tone in children age birth to three years. Six physical therapists were raters. Each rater was randomly assigned to nine evaluations. Eighteen children were evaluated by a group of three raters. The testing protocol included observation of the child's spontaneous movement for 10 minutes, followed by a 10 minute assessment period in which the raters individually assesssed the child using the rater's preferred method of evaluation. Following the evaluation, each rater completed a tone summary form, scoring: (1) clinical impression of abnormality, (2) tone sumary statement, and (3) to...

Pediatric Neurology Handbook.

Disorders of the nervous system and associated abnormalities of development and behavior are frequently encountered in childhood. To aid physicians dealing with these problems, Dr. Jabbour and his collaborators from the University of Tennessee have written a handbook for students of medicine at all levels of sophistication, which the authors further state, not a complete text but is to be used for familiarization and orientation. The Pediatric Neurology Handbook is designed to simplify relatively difficult and confusing neurological subjects. The book is divided into 19 chapters covering a spectrum of problems including development and neurological examination of infants and children, learning disorders, convulsions, and neuromuscular disease. To cover a

The value of transillumination of the skull in neurological examination of neonates and infants.

Transillumination of the skull — a simple and easily executed method of investigation — merits a place in the routine neurological examination of infants. It is a valuable aid in determining the degree of hydrocephalus and in the diagnosis of hydranencephaly. Its finest application is in the detection of unilateral hygromata and the discovery of their recurrences during the post-operative period. The Dandy-Walker syndrome can also be detected with the aid of this method of transillumination.