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[Demand for neuropediatric services at a general referral hospital. IV. Psychomotor development and physical
J López-Pisón1, A Baldellou, V Rebage
1Sección de Neuropediatría, Hospital Miguel Servet, Zaragoza, España.
Insights
Neuropediatric diagnosis relies on thorough history and physical exams. A new specialist found psychomotor retardation in 19% of pediatric patients, with anomalous behavior/mental deficiency being most common.
Area of Science:
- Neurology
- Pediatrics
- Developmental Pediatrics
Context:
- A neuropediatrician was newly appointed to Hospital Miguel Servet, Zaragoza.
- This study covers a 5-year period (May 1990-May 1995).
- The hospital previously lacked a dedicated neuropediatric specialist.
Purpose:
- To evaluate the psychomotor development of children seen by a new neuropediatrician.
- To analyze findings from physical examinations in pediatric patients.
- To establish baseline data for neuropediatric care in the region.
Summary:
- Psychomotor retardation was diagnosed in 19% of evaluated children.
- Significant physical examination data was obtained in 50% of cases.
- Anomalous behavior or suspected mental deficiency (14%) was the most frequent finding, followed by pyramidal, cranial nerve, and phenotypic abnormalities.
Impact:
- Highlights the importance of specialized neuropediatric care.
- Demonstrates the utility of detailed history and physical examination in diagnosis.
- Provides insights into the prevalence of various neurodevelopmental issues in a pediatric population.
Introduction And Objective:
Diagnosis in neuropediatrics requires a detailed personal and family history and thorough physical examination. In this paper we study the psychomotor development and physical examination of children evaluated during a 5 year period, from May 1990 to May 1995 by a neuropediatrician newly appointed to the Hospital Miguel Servet in Zaragoza, which previously did not have such a specialist.
Results:
Psychomotor retardation was seen in 19% of the children. In 50% of the children evaluated, significant data was obtained from the physical examination. The commonest finding, observed in 14% of the children, was of anomalous behaviour or an impression of mental deficiency. In decreasing order of frequency other data were: Diffuse pyramidal involvement, cranial nerve involvement, anomalous phenotype, microcephaly, microsomy, signs of neuromuscular involvement, hemiparesia, macrocephaly, skin markings, scoliosis, signs of extrapyramidal involvement, signs of cerebellar involvement, macrosomy and sensory disorders.
Conclusions:
Diagnosis in neuropediatrics is directed or established, sometimes exclusively, by an extensive personal and family history and adequate interpretation of this, which in the end depends on the skill of the clinician.