Neurologic examination in children

The neurologic examination in children requires an ability to communicate with the parents and child, a knowledge of developmental milestones, and an index of suspicion that encompasses multiple physiologic systems. Observation is the single most important skill. When coupled with the background knowledge to put these observations into their appropriate places, the diagnostic considerations can be dramatically reduced. The use of specialized testing may be minimized by a thorough history, physical examination, and review of prior evaluations. Most neurologic conditions have a slow course. If the diagnosis is not readily defined, a series of follow-up visits may give a clearer picture of the underlying process. Children are constantly changing. The examinations we perform must be infinitely flexible to accommodate this fact.