Clinical Neurological Examination and Localization

The relation of Zika virus (ZIKV) with microcephaly is well established. However, knowledge is lacking on later developmental outcomes in children with evidence of maternal ZIKV infection during pregnancy born without microcephaly. The objective of this analysis is to investigate the impact of prenatal exposure to ZIKV on neuropsychomotor development in children without microcephaly. We evaluated 274 children including 235 ZIKV exposed and 39 controls using the Bayley-III Scales of Infant and Toddler Development (BSIDIII) and neurological examination. We observed a difference in cognition with a borderline p-value (p = 0.052): 9.4% of exposed children and none of the unexposed control group had mild to moderate delays. The prevalence of delays in the language and motor domains did not differ significantly between ZIKV-exposed and unexposed children (language: 12.3% versus 12.8%; motor: 4.7% versus 2.6%). Notably, neurological examination results were predictive of neurodevelopmental delays in the BSIDIII assessments for exposed children: 46.7% of children with abnormalities on clinical neurological examination presented with delay in contrast to 17.8% among exposed children without apparent neurological abnormalities (p = 0.001). Overall, our findings suggest that relative to their unexposed peers, ZIKV-exposed children without microcephaly are not at considerably increased risk of neurodevelopmental impairment in the first 42 months of life, although a small group of children demonstrated higher frequencies of cognitive delay. It is important to highlight that in the group of exposed children, an abnormal neuroclinical examination may be a predictor of developmental delay. The article contributes to practical guidance and advances our knowledge about congenital Zika.

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The Clinical Neurological Examination

Foundations of Environmental and Occupational Neurotoxicology ◽

10.4324/9781351320047-5 ◽

2019 ◽

pp. 58-77

Author(s):

José A. Valciukas

Keyword(s):

Neurological Examination ◽

Clinical Neurological Examination

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Diagnostic neuroimaging in migraine

Oxford Textbook of Headache Syndromes ◽

10.1093/med/9780198724322.003.0003 ◽

2020 ◽

pp. 17-33

Author(s):

Mark C. Kruit ◽

Arne May

Keyword(s):

Risk Factor ◽

Neurological Examination ◽

Laboratory Tests ◽

Brain Lesions ◽

Complex Relationship ◽

Patient History ◽

Clinical Neurological Examination ◽

Migraine Pathophysiology ◽

Acute Headache

This chapter focuses on diagnostic clinical neuroimaging in migraine. In most migraine cases, patient history, details of symptoms, and careful clinical neurological examination are together the most important tools in diagnosing and treating migraine, and, consequently, there is mostly no need for further laboratory tests or neuroimaging. In selected non-acute headache cases, neuroimaging is warranted, and recommendations are provided. Good understanding of the migraine pathophysiology allows better interpretation of neuroimaging findings, notably when patients present acutely, in or outside an attack. The neuroradiological findings relevant in understanding the complex relationship between migraine and stroke will therefore be discussed. Similarly, knowledge of the epidemiological findings that have set migraine as a risk factor for (progressive) subclinical brain lesions is relevant in everyday neuroradiological practice.

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Which Neurological Examinations can be used to Predict Outcome During the Neonatal Period?

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462300012630 ◽

1991 ◽

Vol 7 (S1) ◽

pp. 118-124

Author(s):

Frances Cowan

Keyword(s):

Neurological Examination ◽

Prognostic Value ◽

Neonatal Period ◽

Diagnostic Value ◽

Blood Velocity ◽

Evoked Responses ◽

Clinical Neurological Examination ◽

Velocity Imaging ◽

Ultrasound Measurements ◽

Cerebral Blood Velocity

In this review I shall discuss the prognostic value of the clinical neurological examination, the EEG (and the various methods of recording it), evoked responses, and Doppler ultrasound measurements of cerebral blood velocity. Imaging modalities (ultrasound, CT, MRI) will be dealt with elsewhere under discussion of their diagnostic value.

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Spinocerebellar ataxias

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2009000600035 ◽

2009 ◽

Vol 67 (4) ◽

pp. 1133-1142 ◽

Cited By ~ 35

Author(s):

Hélio A.G. Teive

Keyword(s):

Peripheral Neuropathy ◽

Neurological Examination ◽

Movement Disorders ◽

Spinocerebellar Ataxias ◽

Clinical Algorithm ◽

Molecular Tests ◽

Clinical Neurological Examination ◽

Progressive Cerebellar Ataxia ◽

Different Types ◽

Type 3

Spinocerebellar ataxias (SCAs) constitute a heterogeneous group of neurodegenerative diseases characterized by progressive cerebellar ataxia in association with some or all of the following conditions: ophthalmoplegia, pyramidal signs, movement disorders, pigmentary retinopathy, peripheral neuropathy, cognitive dysfunction and dementia. OBJECTIVE: To carry out a clinical and genetic review of the main types of SCA. METHOD: The review was based on a search of the PUBMED and OMIM databases. RESULTS: Thirty types of SCAs are currently known, and 16 genes associated with the disease have been identified. The most common types are SCA type 3, or Machado-Joseph disease, SCA type 10 and SCA types 7, 2, 1 and 6. SCAs are genotypically and phenotypically very heterogeneous. A clinical algorithm can be used to distinguish between the different types of SCAs. CONCLUSIONS: Detailed clinical neurological examination of SCA patients can be of great help when assessing them, and the information thus gained can be used in an algorithm to screen patients before molecular tests to investigate the correct etiology of the disease are requested.

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