Skip to main content

Neurological Assessment of the Neonate, Infant, Child, and Adolescent

  • Chapter
  • First Online:
Nursing Care of the Pediatric Neurosurgery Patient

Abstract

A bedside nurse is often the first to note a subtle change in a child’s level of responsiveness, pattern of movement, or signs and symptoms of decline in neurological function. Both keen observation skills, and knowledge of the patient’s baseline neurological function are essential tools for the pediatric neurosurgical nurse.

This chapter gives a thorough description of the neurological examination of children in all age groups. Important tables are included so that the reader does not need multiple sources. There are excellent specific patient examples, and tips from the experts on how to perform the neurological examination of the pediatric patient.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 159.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Ali S, Drendel AL, Kircher J, Beno S (2010) Pain management of musculoskeletal injuries in children: current state and future directions. Pediatr Emerg Care 26(7):518–524. doi: 00006565-201007000-00014 [pii]; quiz 525–518

    Article  PubMed  Google Scholar 

  • American Academy of Pediatrics (1996) Eye examination and vision screening in infants, children, and young adults. Pediatrics 98(1):153–157

    Google Scholar 

  • American Academy of Pediatrics (2011) Health issues: bedwetting (enuresis). Healthy Children Website. http://www.healthychildren.org/English/health-issues/conditions/emotional-problems/Pages/Bed-Wetting-Enuresis.aspx. Accessed March 21, 2012

  • Amidei C, Blissett P, Brooks L (2010) Assessment. In: Amidei C (ed) AANN core curriculum for neuroscience nursing, 5th edn. American Association of Neuroscience Nurses, Glenview, pp 107–157

    Google Scholar 

  • Asato MR, Nawarawong N, Hermann B, Crumrine P, Luna B (2011) Deficits in oculomotor performance in pediatric epilepsy. Epilepsia 52(2):377–385

    PubMed  Google Scholar 

  • Brislin RP, Rose JB (2005) Pediatric acute pain management. Anesthesiol Clin North America 23(4):789–814, x

    Article  PubMed  CAS  Google Scholar 

  • Caplin DA, Austin JK, Dunn D (2009) Epilepsy. In: O’Donohue WT, Tolle LW (eds) Behavioral approaches to chronic disease in adolescence: a guide to integrative care. Springer, New York, pp 143–152

    Chapter  Google Scholar 

  • Cohen J (2009) Interrater reliability and predictive validity of the FOUR score coma scale in a pediatric population. J Neurosci Nurs 41(5):261–267; quiz 268–269

    Article  PubMed  Google Scholar 

  • Conn PM (1995) Neuroscience in medicine. J.B. Lippincott, Philadelphia

    Google Scholar 

  • Cook N, Woodward S (2011) Assessment, interpretation and management of altered consciousness. In: Woodward S, Mestecky A-M (eds) Neuroscience nursing: evidence based practice. Blackwell Publishing Ltd., West Sussex

    Google Scholar 

  • Disabato J, Wulf J (1994) Altered neurologic function. In: Betz C, Hunsberger M, Wright S (eds) Family centered nursing care of children, 2nd edn. Saunders, Philadelphia, pp 1717–1840

    Google Scholar 

  • Dlamini N, Billinghurst L, Kirkham FJ (2010) Cerebral venous sinus (sinovenous) thrombosis in children. Neurosurg Clin N Am 21(3):511–527

    Article  PubMed  Google Scholar 

  • Drotar D, Stancin T, Dworkin PH, Sices L, Wood S (2008) Selecting developmental surveillance and screening tools. Pediatr Rev 29(10):e52–e58

    Article  PubMed  Google Scholar 

  • Freedman SB, Al-Harthy N, Thull-Freedman J (2009) The crying infant: diagnostic testing and frequency of serious underlying disease. Pediatrics 123(3):841–848

    Article  PubMed  Google Scholar 

  • Greco C, Berde C (2005) Pain management for the hospitalized pediatric patient. Pediatr Clin North Am 52(4):995–1027, vii-viii

    Article  PubMed  Google Scholar 

  • Greisen G (2006) Brain monitoring in the neonate – the Rationale. Clin Perinatol 33:613–618, v–vi

    Article  PubMed  Google Scholar 

  • Hadley J (1994) Assessing child health. In: Betz C, Hunsberger M, Wright S (eds) Family centered ­nursing care of children, 2nd edn. Saunders, Philadelphia, pp 458–512

    Google Scholar 

  • Hamilton S (2006) Screening for developmental delay: reliable, easy-to-use tools. J Fam Pract 55(5):415–422. doi: jfp_0506_5505c [pii]

    PubMed  Google Scholar 

  • Haymore J (2004) A neuron in a haystack: advanced neurologic assessment. AACN Clin Issues 15(4):568–581. doi: 00044067-200410000-00008 [pii]

    Article  PubMed  Google Scholar 

  • He YZ, Wang ZP, Wang J (2008) Value of Glasgow-Pittsburgh Coma Scale scoring in childhood coma. Zhongguo Dang Dai Er Ke Za Zhi 10(5):614–616. doi: 1008-8830(2008)05-0614-03 [pii]

    PubMed  Google Scholar 

  • Hedlund GL (2002) Neuroradiology of the central nervous system in childhood. Neurol Clin 20(4):965–981, vi

    Article  PubMed  Google Scholar 

  • Hickey J (2009) Neurological assessment. In: Hickey J (ed) The clinical practice of neurological and neurosurgical nursing, 6th edn. Wolters Kluwer/Lippincott Williams & Wilkins, Philadelphia, pp 154–180

    Google Scholar 

  • Hobdell E (2001) Infant neurologic assessment. J Neurosci Nurs 33(4):190–193

    Article  PubMed  CAS  Google Scholar 

  • Iaia A, Barker E (2008) Neurodiagnostic studies. In: Barker E (ed) Neuroscience nursing a spectrum of care, 3rd edn. Mosby/Elsevier, St. Louis, pp 99–130

    Google Scholar 

  • Knowlton RC (2008) Can magnetoencephalography aid epilepsy surgery? Epilepsy Curr 8(1):1–5. doi: 10.1111/j.1535-7511.2007.00215.x

    Article  PubMed  Google Scholar 

  • Kramer U, Nevo Y, Harel S (1994) Jittery babies: a short-term follow-up. Brain Dev 16(2):112–114. doi: 0387-7604(94)90045-0 [pii]

    Article  PubMed  CAS  Google Scholar 

  • Lucille Packard Children’s Hospital (2012) Neurological Examination. Retrieved from http://www.lpch.org/DiseaseHealthInfo/HealthLibrary/neuro/neurexam.html. Accessed 20 Mar 2012

  • Marcoux KK (2005) Management of increased intracranial pressure in the critically ill child with an acute neurological injury. AACN Clin Issues 16:212–231

    Article  PubMed  Google Scholar 

  • McGee S, Burkett KW (2000) Identifying common pediatric neurosurgical conditions in the primary care setting. Nurs Clin North Am 35(1):61–85

    PubMed  CAS  Google Scholar 

  • Merkel SI, Voepel-Lewis T, Shayevitz JR, Malviya S (1997) The FLACC: a behavioral scale for scoring postoperative pain in young children. Pediatr Nurs 23(3):293–297

    PubMed  CAS  Google Scholar 

  • Miró J, Castarlenas E, Huguet A (2009) Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain. Eur J Pain 13(10):1089–1095. doi: S1090-3801(09)00151-7 [pii] 10.1016/j.ejpain.2009.07.002

    Article  PubMed  Google Scholar 

  • Nakagawa, TA, Ashwal, S, Mathur, M, & Mysore, MR. (2011) Guidelines for the determination of brain death in infants and children: an update of the 1987 task force recommendations. Society of Critical Care Medicine, Section on Critical Care and Section on Neurology of the American Academy of Pediatrics, Child Neurology Society, Critical Care Medicine, 39(9):2139–2155. doi: 00003246-201109000-00016 [pii] 10.1097/CCM.0b013e31821f0d4f

  • National Institute of Child Health and Human Development (2012) Pediatric Endocrinology Training Program, Tanner Staging for Females and Males. Retrieved from https://science.nichd.nih.gov/confluence/display/pe/Clinical+Resources. Accessed on March 21, 2012

  • Nellhaus G (1968) Head circumference from birth to eighteen years. Practical composite international and interracial graphs. Pediatrics 41(1):106–114

    PubMed  CAS  Google Scholar 

  • Pasero C, Eksterowicz N, Primeau M, Cowley C (2008) The registered nurse’s role in the management of analgesia by catheter techniques. J Perianesth Nurs 23(1):53–56

    Article  PubMed  Google Scholar 

  • Purugganan OH (2006) Abnormalities in head size. Pediatr Rev 27(12):473–476. doi: 27/12/473 [pii]

    Article  PubMed  Google Scholar 

  • Randive S, Mehta V (2012) Breakthrough pain-novel analgesics. Curr Clin Pharmacol. doi: CCP-EPUP-20120320-003 [pii]

  • Rosen DA, Dower J (2011) Pediatric pain management. Pediatr Ann 40(5):243–252. doi: 10.3928/00904481-20110412-05

    Article  PubMed  Google Scholar 

  • Santrock, JW (1998) Physical growth and development in infancy, in Physical and Cognitive Development in Infancy, JW Santrock, ed. chapter 3. Retrieved from highered.mcgraw-hill.com/sites/dl/free/0073405515/519572/Santrock_ch3.pdf. Accessed on Oct. 27, 2012

    Google Scholar 

  • Schultz R, Hockenberry M (2011) The child with cerebral dysfunction. In: Hockenberry MJ, Wilson D (eds) Wong’s Nursing care of infants and children, 9th edn. St. Louis, Elsevier/Mosby, pp 1507–1566

    Google Scholar 

  • Shuper A, Zalzberg J, Weitz R, Mimouni M (1991) Jitteriness beyond the neonatal period: a benign pattern of movement in infancy. J Child Neurol 6(3):243–245

    Article  PubMed  CAS  Google Scholar 

  • Slota MC (1983a) Neurological assessment of the infant and toddler. Crit Care Nurse 3(5):87–92

    PubMed  CAS  Google Scholar 

  • Slota MC (1983b) Pediatric neurological assessment. Crit Care Nurse 3(6):106–112

    PubMed  CAS  Google Scholar 

  • Stapelkamp C, Carter B, Gordon J, Watts C (2011) Assessment of acute pain in children: development of evidence-based guidelines. Int J Evid Based Healthc 9(1):39–50. doi: 10.1111/j.1744-1609.2010.00199.x

    Article  PubMed  Google Scholar 

  • Stevens B, Johnston C, Taddio A, Gibbins S, Yamada J (2010) The premature infant pain profile: evaluation 13 years after development. Clin J Pain 26(9):813–830. doi: 10.1097/AJP.0b013e3181ed1070

    Article  PubMed  Google Scholar 

  • Teo JH, Palmer GM, Davidson AJ (2011) Post-craniotomy pain in a paediatric population. Anaesth Intensive Care 39(1):89–94

    PubMed  CAS  Google Scholar 

  • Togioka BM, Arnold MA, Bathurst MA, Ziegfeld SM, Nabaweesi R, Colombani PM, Abdullah F (2009) Retinal hemorrhages and shaken baby syndrome: an evidence-based review. J Emerg Med 37(1):98–106. doi: S0736-4679(08)00617-3 [pii] 10.1016/j.jemermed.2008.06.022

    Article  PubMed  Google Scholar 

  • U.S. Department of Education Special Education and Rehabilitative Services (2005) Individuals with Disabilities Education Act. U.S. Department of Education, Washington, D.C., Retrieved from www.ed.gov/about/offices/list/osers/osep

    Google Scholar 

  • Volpe JJ (2009) The encephalopathy of prematurity – brain injury and impaired brain development inextricably intertwined. Semin Pediatr Neurol 16(4):167–178. doi: S1071-9091(09)00063-1 [pii] 10.1016/j.spen.2009.09.005

    Article  PubMed  Google Scholar 

  • Wallace, D & Disabato, J (2007) Age appropriate assessment table. Adapted from Children’s Rehabilitative Services, St. Joseph’s Hospital, Phoenix, AZ

    Article  PubMed  Google Scholar 

  • Wijdicks EF, Bamlet WR, Maramattom BV, Manno EM, McClelland RL (2005) Validation of a new coma scale: the FOUR score. Ann Neurol 58(4):585–593. doi: 10.1002/ana.20611

    Article  PubMed  Google Scholar 

  • Yang M (2004) Newborn neurologic examination. Neurology 62(7):E15–E17

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jennifer A. Disabato DNP, CPNP-PC, AC .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Disabato, J.A., Daniels, D.A. (2013). Neurological Assessment of the Neonate, Infant, Child, and Adolescent. In: Cartwright, C., Wallace, D. (eds) Nursing Care of the Pediatric Neurosurgery Patient. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-32554-0_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-32554-0_1

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-32553-3

  • Online ISBN: 978-3-642-32554-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics