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There are many ways you can help children and their families get the care they need.
We understand that you may have a lot of questions when you learn that your child needs a neurological exam:
We’ve tried to provide some answers to those questions here, and your child’s doctor can talk more about the exam with you when you meet.
What is a neurological exam?
A neurological exam is a simple series of tests that allows your child’s doctor to watch her nervous system in action and can asses her:
There are different parts to a standard neurological exam, and the ones that your child’s doctor focus on depends on factors including your child’s symptoms, age and health.
Why does my child need a neurological exam?
If your child’s nervous system isn’t working properly, it can cause delays in her normal development and functioning. Early detection means that we have a better chance of identifying the cause, quickly treating her and decrease the chance that she’ll have long-term complications.
Your child’s doctor may request a neurological exam if your child:
Neurological exams may also be performed during a routine physical exam, either right after birth, or later in childhood or adolescence, in order to investigate possible problems or rule something out.
Where is the exam performed?
They’re done right in a doctor’s office, usually a neurologist. If your child is in the hospital being treated for something else, it can often be done in her room, too.
How long does the exam take?
The first thing the doctor will do is talk to you and your child about her symptoms, in order to get a good idea of which areas to concentrate on. After that part, the actual exam takes about 30 minutes.
What happens during a neurological exam?
Our pediatric neurologists talk to you and your child, and take your child’s medical history. Based on what we learn, we form theories about what may be causing the symptoms. Then, we perform a series of “tests” that let us do two things: gain more information about how your child’s central nervous system is functioning, and test the theories we’ve made from the interview.
The most common neurological tests look at:
1. Mental status. We’ll assess your child’s level of awareness and how she interacts with the environment. As you can imagine, the way we do this is highly dependent on her age. For older children, we ask them to follow directions or answer questions. For younger children, we watch how they interact with their parents.
2. Motor function and balance. If your child is old enough, we may ask her to:
We may check how her joints move. If your child isn’t old enough to follow instructions, we may just observe how she moves.
3. Sensory perception. This examines your child’s ability to feel. We may touch your child's legs, arms or other parts of her body and have her identify the sensation (hot/cold, sharp/dull).
4. Reflexes. If your child is older, we examine her reflexes by gently tapping a small, soft reflex hammer on different points on her body.
5. Cranial nerves. There are 12 main nerves of the brain, called the cranial nerves, each of which has a number. During a complete neurological exam, we evaluate most of them, but we may choose to concentrate on certain areas, depending on her symptoms. Here’s a breakdown of the cranial nerves, what they’re responsible for and how we test them:
Cranial nerve(s) and number
We may ask your child to
olfactory nerve (I)
optic nerve (II)
trochlear nerve (IV)
abducens nerve (VI)
acoustic nerve (VIII)
glossopharyngeal nerve (IX)
trigeminal nerve (V)
facial nerve (VII)
vagus nerve (X)
accessory nerve (XI)
hypoglossal nerve (XII)
Can you give a neurological exam to an infant?
Yes — newborns and infants have a special series of reflexes that we can test, including:
Each one of these reflexes disappear at a certain age.
When do we get the results of the exam?
Right after the exam. Your child’s doctor will talk with you about the initial hypothesis, what the exam showed, and what your next steps should be. The exam may indicate that another test is needed, such as a blood test, an MRI or a nerve conduction study. Your child’s doctor will be happy to answer any questions you may have.
We are grateful to have been ranked #1 on U.S. News & World Report's list of the best children's hospitals in the nation for the third year in a row, an honor we could not have achieved without the patients and families who inspire us to do our very best for them. Thanks to you, Boston Children's is a place where we can write the greatest children's stories ever told.”