Musculoskeletal complaints are among the most frequent reasons for children to present to a primary care office, walk-in clinic, or emergency room. While the child and parents may be focusing on what they perceive to be a localized problem, complaints…
Eye and Visual System Anatomy The anatomies of the eye and visual system are shown in Figs. 43.1 and 43.2 . The optic nerves, made up of the converging nerve fiber layer of the retina, have intraocular, intraorbital, intracanalicular, and…
Encephalitis , or inflammation of the brain, and myelitis , or inflammation of the spinal cord, cause myriad symptoms and signs because of the subtle behavioral phenotypes and varying locations of the inflammation. The lesions are hard to categorize or…
Altered Mental Status Altered mental status (AMS) refers to a broad range of nonspecific symptoms indicating a change in brain function from a patient’s baseline and can include confusion, alteration in consciousness, disorientation, decreased awareness, amnesia, and change in behavior.…
The clinical evaluation of childhood movement disorders depends on the crucial step of phenomenology that precedes and guides evaluation and management. Historically, many of the chronic movement disorders were identified as phenotypic syndromes based on clinical presentation, associated symptoms, and…
Paroxysmal disorders can be broadly classified into epileptiform and nonepileptic events. The nonepileptic episodes are often referred to by the generic term spells . They may mimic epileptic seizures but are not associated with the typical rhythmic EEG patterns characteristic…
Definitions Tone is defined as resistance to passive stretch while a patient is attempting to maintain a relaxed state of muscle activity. Tone can be divided into postural tone, which represents the steady flexion or extension of a joint caused…
Stroke is a sudden focal neurologic syndrome caused by an abrupt and critical interruption of the normal metabolic function of the central nervous system (CNS), typically due to ischemia or hemorrhage. Depending on where in the CNS this interruption occurs,…
Rhabdomyolysis Rhabdomyolysis is an acute muscle injury resulting in myocyte cell death with subsequent release of toxic intracellular compounds producing muscle and systemic symptoms. This differs from hyperCKemia, in which there is elevated creatine kinase in the serum secondary to…
Muscle Weakness and Hypotonia As a symptom, hypotonia may be overt in its presentation, with the manifestations of low muscle tone apparent to family and the medical team alike. Other times, hypotonia may be insidious, subtly presenting to an examiner…