Week 2-Neurological disorders in children

Neurologic disorders in children Pediatric Differences in the Central Nervous System ● The nervous system is not mature at birth ● The brain constitutes 12% of a newborn’s body weight ● An infant’s brain is highly vascular and the dura can strip away from the pericranium Pediatric Differences in the Central Nervous System, cont’d ● At birth and during early childhood, fontanels are not closed and bones have not ossified ● Young infants have a proportionally large, heavy head compared with adults ● An infant has 50 mL of cerebrospinal fluid; adults have 150 mL Pediatric Differences in the Central Nervous System, cont’d • Papilledema rarely occurs in infancy because of the open fontanels and sutures • Peripheral nerves are not completely myelinated at birth • Vertebrae are not completely ossified • Reappearance of primitive reflexes (moro, grasp, rooting) after 5 months of age is associated with neurological disease Assessment of the Pediatric Nervous System • Children younger than 2 years require special evaluation because they are unable to respond to directions designed to elicit specific neurological responses • Most information about infants and small children is gained through observation of spontaneous and elicited reflex responses • Red flags include delay or deviation from expected milestones and persistence or reappearance of reflexes that normally disappear ........................................continued..........................................