Pediatric Neurological Examination

What is a neurological exam?

神经学检查是一系列简单的测试，使您的孩子的医生能够看着她的神经系统，并可以评估她：

• mental status (level of awareness and interaction with the environment)
• 运动和感官技能
• 平衡与协调
• 反射

There are different parts to a standard neurological exam, and the ones that your child’s doctor focus on depends on factors including your child’s symptoms, age and health.

Why does my child need a neurological exam?

If your child’s nervous system isn’t working properly, it can cause delays in her normal development and functioning. Early detection means that we have a better chance of identifying the cause, quickly treating her and decrease the chance that she’ll have long-term complications.

如果您的孩子，您孩子的医生可能会要求进行神经检查：

• 抱怨症状包括：
• headaches
• 视力模糊
• 疲劳
• 发烧未知原因
• change in balance or coordination
• 胳膊或腿麻木或刺痛
• decrease in movement of the arms or legs
• tremor
• 她的头，脖子或背部受伤
• is experiencing a change in behavior, or in balance or coordination
• has any type of birth defect to her head or spine
• is currently being treated for a disease or condition

为了调查可能的问题或排除某些事情，也可以在常规身体检查中（无论是在出生后还是晚些时候）进行神经检查。

考试在哪里进行？

他们通常是由神经科医生在医生的办公室里完成的。如果您的孩子在医院接受其他治疗，通常也可以在她的房间里完成。

How long does the exam take?

The first thing the doctor will do is talk to you and your child about her symptoms, in order to get a good idea of which areas to concentrate on. After that part, the actual exam takes about 30 minutes.

神经检查期间会发生什么？

我们的儿科神经科医生与您和您的孩子交谈，并了解您孩子的病史。根据我们学到的知识，我们形成了有关可能导致症状的原因的理论。然后，我们执行一系列“测试”，让我们做两件事：获得有关孩子的中枢神经系统如何运作的更多信息，并测试我们从访谈中制作的理论。

最常见的神经系统测试探讨了：

• Mental status.我们将评估您孩子的意识水平以及她如何与环境互动。可以想象，我们这样做的方式高度依赖她的年龄。对于年龄较大的孩子，我们要求他们遵循指示或回答问题。对于年幼的孩子，我们观看他们如何与父母互动。
• Motor function and balance.如果您的孩子足够大，我们可能会请她：
  • push and pull against the doctors hands with her arms and legs
  • hop, skip or jump
  • 戴上尖端，脚后跟走，脚外走或脚内行走
  • squeeze fingers
  • stand with her eyes closed while being gently pushed to one side
  We may check how her joints move. If your child isn’t old enough to follow instructions, we may just observe how she moves.
• 感官知觉。这检查了您孩子的感觉能力。我们可能会触摸您孩子的腿，手臂或身体的其他部位，并让她确定这种感觉（热/冷，尖锐/暗淡）。
• 反射。如果您的孩子年纪大了，我们会通过轻轻敲击她身体上不同点的小而柔软的反射锤来检查她的反射。
• 颅神经。There are 12 main nerves of the brain, called the cranial nerves, each of which has a number. During a complete neurological exam, we evaluate most of them, but we may choose to concentrate on certain areas, depending on her symptoms. Here’s a breakdown of the cranial nerves, what they’re responsible for and how we test them:



Cranial nerve(s) and number	帮助	We may ask your child to:
嗅觉神经（i）	smell	闭上眼睛识别出不同的气味
optic nerve (II)	vision	在图表上识别字母，形状或图片 也许识别不同的颜色
动眼（III） trochlear nerve (IV) abducens nerve (VI)	moving the eyes 保持它们“连接” 控制学生的大小	use her eyes to follow a moving light or a moving finger while her doctor examines her eyes with a different light
声学神经（VIII）	hearing 平衡	identify when she hears certain sounds
全咽神经（IX）	味道 吞ing	识别出舌头背面的不同口味 吞咽医生看着她的味蕾动作
trigeminal nerve (V)	触碰 下颌肌肉的运动	bite down while doctor touches different areas of her face 嚼 close her jaw against slight resistance
面神经（vii）	味道 面部肌肉的运动	identify different tastes (sweet, sour, bitter) 微笑 移动她的脸颊 展示她的牙齿
vagus nerve (X)	味道 移动	吞 她的医生可能使用舌刀来引起插科打响应
accessory nerve (XI)	移动	turn her head from side to side against mild resistance 耸耸肩
降低神经（XII）	移动of tongue	伸出她的舌头 说话

Can you give a neurological exam to an infant?

是的 - 新生儿和婴儿有一系列特殊的反射，我们可以测试，包括：

• blinking: your infant will close her eyes in response to bright lights
• Babinski reflex: as your infant's foot is stroked, her toes will extend upward
• 爬行：如果您的婴儿被放在她的腹部，她会做爬行的动作
• Moro's reflex: a quick change in your infant's position will cause her to throw her arms outward, open her hands, and throw back her head
• startle: a loud noise will cause your infant to extend and flex her arms while her hands remain closed in a fist
• 手掌和足底抓握：她的手指或脚趾会卷曲在该区域的手指周围

Each one of these reflexes disappear at a certain age.

When do we get the results of the exam?

Right after the exam. Your child’s doctor will talk with you about the initial hypothesis, what the exam showed, and what your next steps should be. The exam may indicate that another test is needed, such as a blood test, anMRI，或神经传导研究。您孩子的医生将很高兴回答您可能遇到的任何问题。

How Boston Children's Hospital approaches neurological exams

The神经病学系at Boston Children's is the oldest, largest, and best-known program in pediatric neurology in the world. We have been ranked #1 in neurology and neurosurgery byob 游戏 。

Our department includes child neurologists with special expertise in such areas as癫痫,学习障碍和其他developmental disabilities,注意缺陷障碍,sleep disorders, neuromuscular disorders,brain tumors, neurogenetic disorders, neonatal neurology, intellectual disability andcerebral palsy, pediatric neuro-immunology, and pediatricmultiple sclerosis以及相关疾病，以及其他儿童的神经系统疾病。您和您的孩子与我们在一起。