Paediatric Neurological Examination

Question 1

for toddlers, the initial phase of the examination is best done with the child situated

Answer 1

on the parents lap

Question 2

assessing higher cortical functions

Answer 2

observe the child during play and look for
- attention span
- gross and fine motor coordination
- problem solving abilities

Question 3

olfactory nerve (1)

Answer 3

test the ability to detect a smell with the childs eyes closed
not assessed in small children or infants
may be impaired after closed head injury and in infants with arhinencephaly-holoprosencephaly

Question 4

optic nerve (2)

Answer 4

the optic nerve is responsible for vision and afferent pupillary light reflexes
test visual acuity
visual fields
pupillary reflexes
fundoscopy

Question 5

testing visual acuity in an infant

Answer 5

observe the infant reach for objects of varying size

Question 6

testing visual acuity in >6 months old

Answer 6

observe reaching for scraps of paper less than 5mm in size when placed on a dark background

Question 7

testing visual acuity in older children

Answer 7

standard recognition of letters, numbers or shapes on a Snellen chart

Question 8

visual feilds

Answer 8

introduce objects into the peripheral field of vision as the child focuses on an object held directly in front of them
note if the child becomes aware of the peripheral object

Question 9

pupillary reflexes are best done in

Answer 9

a dimply lit room