By Jeffrey P. Greenfield, Caroline B. Long
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Additional info for Common Neurosurgical Conditions in the Pediatric Practice: Recognition and Management
Rapid foot tapping is an analogous test in the lower extremities. Note that mild weakness will tend to slow any rapid alternating movements, and thus this is a good test for evaluating subtle unilateral weakness in a hand or foot, by comparing speed of movements to the other side. Testing coordination is not feasible in newborns and infants, due to lack of established circuitry, in addition to the obvious inability to follow commands. By several months of age, however, simply testing for abnormal movements upon reaching for objects will give some sense of coordination and must of course be compared to the abilities of other children at that age.
Brachial plexus birth palsy (BPBP) is an uncommon but critically important complication of the delivery process that must be identiﬁed early. These cases demonstrate a range of presenting severity of neonatal brachial plexus injury and highlight some of the resulting deﬁcits. Understanding this pathology demands an understanding of the relevant gross and functional anatomy, as well as the factors one must consider in approaching its management. Anatomy and Mechanisms of Injury The brachial plexus is a network of nerves arising from the nerve roots of C5–T1 and innervating the muscles and skin of the upper back, chest, and arm (Fig.
Opening the jaw is due to the action of the external pterygoids while closing the jaw is due to the masseter and temporalis. In neonates the muscles of mastication can be tested indirectly by evaluation of sucking strength and control and more directly by allowing the infant to bite on your ﬁngers. VII: The Facial Nerve The facial nerve controls the muscles of facial expression and also mediates taste on the anterior two thirds of the tongue. In cooperative children, facial nerve integrity can be demonstrated by noting strong eye closure, wrinkling of the eyebrows, smiling, and strong pufﬁng out of the cheeks.
Common Neurosurgical Conditions in the Pediatric Practice: Recognition and Management by Jeffrey P. Greenfield, Caroline B. Long