RT Book, Section
A1 Carney, Paul R.
A1 Geyer, James D.
A2 Carney, Paul R.
A2 Geyer, James D.
SR Print(0)
ID 6650001
T1 Chapter 1. History and Examination
T2 Pediatric Practice: Neurology
YR 2010
FD 2010
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-148925-6
LK accesspediatrics.mhmedical.com/content.aspx?aid=6650001
RD 2024/04/19
AB Children  who  present  with  neurological  problems  or  developmental  abnormalities  on  general  physical  examination  should  undergo  a  complete  neurological  assessment.1,2  Initially,  as  much  information  as  possible  from  the  parents  or  caregivers  should  be  obtained  during  the  first  visit.  During  the  initial  clinical  encounter,  the  examiner  should  formulate  an  opinion  regarding  possible  causes  (Table  1-1).  A  diagnostic  hypothesis  can  then  be  confirmed,  supported,  or  rejected  by  the  neurological  and  physical  examinations,  laboratory  tests,  and  other  tests.  A  clear  chief  complaint  is  probably  one  of  the  most  important  first  steps,  and  is  best  elicited  from  the  child,  parents,  or  caretakers.  It  is  common  that  school-age  children  may  often  provide  their  own  chief  complaint.  The  chief  complaint  should  represent  the  exact  words  or  expression  of  the  child  or  parent  and  not  a  reinterpretation  of  the  symptoms  by  the  physician.  Ideally,  the  child  or  parent  should  be  allowed  to  freely  tell  the  story  without  interruption  or  distractions.  However,  brief  directed  questions  can  help  focus  the  interview,  especially  if  the  history  begins  to  wander.  It  is  important  to  note  that  one  should  be  certain  that  interrupting  will  not  result  in  suppression  or  skewing  of  important  information  and  the  parent's  concerns.