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 highl
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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
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