Neurological exam - Pediatric

Dear Physicians

The Corona virus has presented Neurologists with a true challenge , having to preform a full Neurological examination from afar, using digital tools. 

Despite the difficulty, it is possible to preform a thorough Neurological examination, despite the hardshi, but certain elements must be taken into account that can't be done from afar, such as Ophthalmologic and Vestibular examinations, Sensory losses and slight weaknesses. 

The AAN published guidelines for adults, which you can watch in the attached link. On this page you will find the a suggestion for adjusting the exam for the pediatric population, while acknowledging that different ages will need different adjustments. 


Initial observation:

Dysmorphism

No signs of blunt dysmorphism 

No obvious skin stains by parental report


Quality of interaction

Interaction throughout the meeting is age appropriate


Cranial nerves

Equal pupils (if possible to observe with high resolution)

Follows an object in all directions normally 

Sy,metrical face , smile seems symmetrical 

Central tongue , normal sounding voice, no salivation 


Muscle strenth and stability 

No noticable atrophy of muscles, no obvious signs of hemiparesis

Hand and Legs move in symmetry 

No signs of weakness in sitting or standing

Jump is age appropriate


Cerebellar testing

No signs of dysmmetry, ataxia or nistagmus.


For the full guidelines of the AAN, click here:


https://youtu.be/KGlFCWWZGCY


Good Luck!