In the neurological assessment
of the child don’t neglect the general physical examination. Some
of the parts of the general examination that are particularly important
to note are the following:
Somatic growth - measure height and weight and
compare percentiles with head circumference.
Search for dysmorphic features -
carefully study the face especially the midface. There is the old adage
that the face reflects the brain because
anomalies of the midface are often associated with underlying brain malformations.
examination - children are often uncooperative and it is hard to get
a good look at the fundus but patience and perseverance pays off. The
retina is said to be the window to the brain and the retinal examination
valuable information for the neurological assessment.
Skin search - a careful
complete skin search is important. Look for the stigmata of the neurocutaneous
syndromes such as café au lait
or ash leaf lesions.
Abdomen - palpate for visceromegaly, which can indicate
the presence of one of the storage diseases.
Spine - look for scoliosis
and any sacral anomalies.