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.…
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…
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…
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…
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…
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…
A cramp is an involuntary painful contraction of a muscle or part of a muscle. Cramps can occur in normal children during or after vigorous exercise, and after excessive loss of fluid or electrolytes. The characteristic electromyography (EMG) finding for…
The majority of children with flaccid limb weakness have a motor unit disorder. Flaccid leg weakness may be the initial feature of disturbances in the lumbosacral region, but other symptoms of spinal cord dysfunction are usually present. Consult Box 12.1…
Tone is the resistance of muscle to stretch. Clinicians test two kinds of tone: phasic and postural. Phasic tone is a rapid contraction in response to a high-intensity stretch (deep tendon reflexes). Striking the patellar tendon briefly stretches the quadriceps…
Psychomotor retardation or developmental delay refers to the slow progress in the attainment of developmental milestones. This may be caused by either static ( Box 5.1 ) or progressive ( Box 5.2 ) encephalopathies. In contrast, psychomotor regression refers to…