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How Pediatricians Should Identify Neurological Injuries

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As a parent, you know your child, but it is often difficult to identify medical conditions very early on in their their life. You may even have a sense that something is amiss but be unsure as to what is wrong. You trust your child’s pediatrician to recognize signs of a possible health issue and to uncover the source of the problem. This is true for neurological conditions and a vast array of others.

Recognizing the Signs of Neurological Injury in Your Child

A pediatrician is often the first and most important primary healthcare provider in a child’s life. As such, they are tasked with identifying the symptoms of neurological problems in newborns, infants, and young children.

A neurological disorder is any condition affecting the nervous system, including the nerves, brain, and spinal cord. These conditions can result in a wide range of symptoms and complications, including cognitive impairments, paralysis, muscle weakness, loss of sensation, and developmental delays.

In a presentation at the American Academy of Pediatrics National Conference and Exhibition, Dr. Susy S. Jeng, MD, FAAP, discussed key recommendations for pediatricians in diagnosing neurological disorders. The session, entitled “Big problems in baby brains: Neurologic diagnosis and management,” addressed recommended screenings and tests to diagnose the following neurologic conditions:

  • Macrocephaly: an abnormally large head, often the result of hydrocephalus
  • Brachial plexus injury: damage to the network of nerves that controls movement and sensation in the shoulder, arm, and hand
  • Hypotonia: floppy baby syndrome, marked by lack of muscle tone and muscle strength
  • Global developmental delay (GDD): delays in multiple areas of development, including crawling, walking, sitting, speech, or language development
  • Seizures: sudden, abnormal electrical activity in the brain
  • Neurocutaneous disorders: occurs when tumors develop inside various parts of the body

Not only is it imperative that pediatricians be aware of and continuously looking for signs of these and other neurological conditions, they must also refer the patient to a qualified pediatric neurologist for further diagnosis and treatment.

Pediatric Screening & Tests for Childhood Neurological Conditions

Dr. Jeng explained the range of exams and tests that pediatricians should use to identify possible neurological conditions in their young patients. She noted that pediatricians should routinely evaluate newborns and infants for the Moro reflex, which is a key indicator of possible brachial plexus injury. A child who cannot use both hands equally when prompted by the Moro reflex test may have experienced an injury to the brachial plexus during birth.

If an infant is showing signs of hypotonia, which is evidenced by floppy muscles, poor muscle tone, and lack of muscle strength, this is an important sign that they may have a serious condition affecting the central nervous system or peripheral nerves. Pediatricians should also routinely measure the size of a baby’s head, as an unusually large head circumference may indicate a dangerous condition like hydrocephalus. In fact, babies identified with macrocephaly (large head), should have tests to determine intracranial pressure immediately.

Jeng noted that not all abnormal movements or shaking means an infant is having a seizure. Nevertheless, seizure disorders can indicate an underlying brain condition like cerebral palsy. Using image tests like magnetic resonance imaging (MRI) is essential when a child is potentially affected by seizures. These tests are also a valuable tool when diagnosing global developmental delay.

Lastly, physical examinations should be regularly done to identify signs of a neurocutaneous disorder. Examining birthmarks on your baby, as well as continuously looking for pigmented areas on the skin or lesions in older children is absolutely necessary. In some cases, a neurocutaneous disorder will not show signs until the child is a few years old.

When a Pediatrician Fails to Diagnose or Treat a Child’s Neurological Disorder

By assessing and identifying signs and symptoms of neurological problems, pediatricians can facilitate early intervention and support better outcomes for the child long-term. They can also provide necessary education to parents and caregivers. Once a neurological condition has been diagnosed, pediatricians should work with a multidisciplinary team of healthcare providers to monitor and assist your child in living his or her best life.

It is important to note that neurologic injuries may be caused by medical mistakes during labor and delivery, failure to diagnose infection during pregnancy, and negligent pediatric care after birth. If you would like to discuss your legal options as it relates to a childhood brain condition, please feel free to call 866-708-8617 or contact us online today. A knowledgeable member of our legal team is here to assist you.


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