Fenichel's Clinical Pediatric Neurology

Disorders of Cranial Volume and Shape

The brain, cerebrospinal fluid (CSF), and blood are the three intracranial compartments that determine the size of the skull during infancy. Expansion of one compartment comes at the expense of another in order to maintain volume and pressure (see Chapter…

Lower Brainstem and Cranial Nerve Dysfunction

This chapter will review disorders causing dysfunction of the VII through XII cranial nerves. Many such disorders also disturb ocular motility and the discussion of these is in Chapter 15 . The basis for chapter assignment is by the most…

Disorders of the Visual System

Both congenital and acquired visual impairments in children are often associated with neurological disorders. The most common visual disorders are uncorrected refractive errors, amblyopia, strabismus, cataracts, and genetic disorders. Assessment of visual acuity The assessment of visual acuity in preverbal…

Disorders of Ocular Motility

The maintenance of binocular vision requires harmonious function of the visual sensory system, gaze centers, ocular motor nerves, neuromuscular junction, and ocular muscles. This chapter deals with nonparalytic strabismus, paralytic strabismus (ophthalmoplegia), gaze palsies, ptosis, and nystagmus. The discussion of…

Movement Disorders

Involuntary movements are usually associated with abnormalities of the basal ganglia and their connections and occur in several different neurological disorders. Abnormal movements can be the main or initial features of disease, or they can occur as a late manifestation.…

Monoplegia

Weakness or paralysis of a limb is usually due to pathology of the spine and the proximal portion of nerves. Monoplegia may also be the initial presentation of a hemiplegia, paraplegia, or quadriplegia. Therefore one must also consult the differential…

Paraplegia and Quadriplegia

In this text, the term paraplegia denotes partial or complete weakness of both legs, and the term quadriplegia denotes partial or complete weakness of all limbs, thereby obviating need for the terms paraparesis and quadriparesis . Many conditions described fully…

Hemiplegia

The approach to children with hemiplegia must distinguish between acute hemiplegia, in which weakness develops within a few hours, and chronic progressive hemiplegia, in which weakness evolves over days, weeks, or months. The distinction between an acute and an insidious…

Ataxia

The term ataxia denotes disturbances in the fine control of posture and movement. The cerebellum and its major input systems from the frontal lobes and the posterior columns of the spinal cord provide this control. The initial and most prominent…

Sensory and Autonomic Disturbances

This chapter deals primarily with sensory disturbances of the limbs and trunk. Autonomic dysfunction is often associated with sensory loss but sometimes occurs alone. Chapter 17 considers sensory disturbances of the face. Sensory symptoms Pain, dysesthesias, and loss of sensibility…