Neurological assessment

Author(s):  
Tina Moore
2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Stefania Longo ◽  
Camilla Caporali ◽  
Camilla Pisoni ◽  
Alessandro Borghesi ◽  
Gianfranco Perotti ◽  
...  

AbstractPreterm very low birth weight infants (VLBWi) are known to be at greater risk of adverse neurodevelopmental outcome. Identifying early factors associated with outcome is essential in order to refer patients for early intervention. Few studies have investigated neurodevelopmental outcome in Italian VLBWi. The aim of our longitudinal study is to describe neurodevelopmental outcome at 24 months of corrected age in an eleven-year cohort of 502 Italian preterm VLBWi and to identify associations with outcome. At 24 months, Griffiths’ Mental Developmental Scales were administered. Neurodevelopmental outcome was classified as: normal, minor sequelae (minor neurological signs, General Quotient between 76 and 87), major sequelae (cerebral palsy; General Quotient ≤ 75; severe sensory impairment). 75.3% showed a normal outcome, 13.9% minor sequelae and 10.8% major sequelae (3.8% cerebral palsy). Male gender, bronchopulmonary dysplasia, abnormal neonatal neurological assessment and severe brain ultrasound abnormalities were independently associated with poor outcome on multivariate ordered logistic regression. Rates of major sequelae are in line with international studies, as is the prevalence of developmental delay over cerebral palsy. Analysis of perinatal complications and the combination of close cUS monitoring and neurological assessment are still essential for early identification of infants with adverse outcome.


1977 ◽  
Vol 8 (S 01) ◽  
pp. 505-506
Author(s):  
L. Dubowitz ◽  
V. Dubowitz

PEDIATRICS ◽  
1976 ◽  
Vol 57 (4) ◽  
pp. 521-525
Author(s):  
Robert J. Lerer ◽  
M. Pamela Lerer

The neurological examination of many hyperactive children reveals the presence of abnormal neurological signs. Of 40 hyperactive children who had three or more neurological abnormalities on an initial neurological evaluation, 29 (72.5%) showed marked improvement or complete resolution of the neurological signs following treatment with methylphenidate hydrochloride (Ritalin) for 60 days. The administration of placebo did not change appreciably the neurological status of 20 hyperactive children. Improvement in behavior, which was ascertained by the use of Conners' Abbreviated Teacher Rating Scale, did not always correspond with resolution of the abnormal neurological signs. This finding suggests that methylphenidate affects behavioral and motoric functions separately and independently. Repeat neurological assessment, looking for resolution of abnormal neurological signs, should be included as part of the follow-up medical examination in treated hyperactive children. Coupled with other objective and subjective test information, improvement of the neurological status provides supportive evidence of overall improvement in the hyperactive child who is receiving drug therapy.


Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Katja Bryant ◽  
Kim Anda ◽  
Leslie Busby ◽  
Deborah Camp ◽  
Kerrin Connely ◽  
...  

The current clinical practice guidelines (CPG) based on the NINDS trial from 1995 recommend that vital signs and neuro checks are completed Q15 min x 2 hrs., Q 30 min x 6 hrs., Q 1 hour x 16 hrs. post administration of IV t-PA. The half-life (t ½α ) of Alteplase is <5 min, therefore the current vigilance of neurological assessments may not be necessary. The purpose of this study was to evaluate the timing of when a symptomatic intracranial hemorrhage (sICH) occured in relation to the administration of IV t-PA. Results: A total of 569 patients who received IV t-PA were reviewed. Nine patients, with a mean age of 70 ± 17 years and mean NIHSS of 11, were diagnosed with a sICH within 36 hrs. post IV t-PA administration. The mean time of detecting sICH post IV t-PA administration was 294 minutes. The shortest time was 77 min and the longest time was 814 min (13 hrs and 34 min). The vast majority (77%) of the sICH complications were diagnosed in less than 6 hrs. Conclusions: This analysis suggests that sICH occurs early in the course after administration of IV t-PA. Future guidelines may consider reducing the neurological assessment frequency after 12 hours from IV t-PA administration. Prospective controlled studies are required to validate these results.


Medicina ◽  
2020 ◽  
Vol 56 (9) ◽  
pp. 475
Author(s):  
Domenico M. Romeo ◽  
Martina Ricci ◽  
Maria Picilli ◽  
Benedetta Foti ◽  
Giorgia Cordaro ◽  
...  

Background and Objectives: Late preterm (LP) infants (born between 34 and 36 weeks of gestational age) are considered at higher risk of neonatal morbidities, mortality, and neurological impairments than full-term born infants (FT). The aim of this study was to provide a critical review of the literature outlining the different aspects of neurological function reported both in the neonatal period and in the follow up of late preterm infants. Materials and Methods: A comprehensive search of the MEDLINE, Embase, PsycINFO, and CINAHL electronic databases was made, using the following search terms: ‘Late preterm infants’, ‘Near term infants’, ‘neurological assessment’, ‘neurological outcome’, ‘neuromotor outcome’, cerebral palsy’, ‘CP’, ‘motor impairment’, including all the studies reporting clinical neurological assessment of LP (including both neonatal period and subsequent ages). Results: A total of 35 articles, comprising 301,495 children, were included as fulfilling the inclusion criteria: ten reported neonatal neurological findings, seven reported data about the first two years after birth, eighteen reported data about incidence of CP and motor disorder during the infancy. Results showed a more immature neurological profile, explored with structured neurological assessments, in LP infants compared with FT infants. The LP population also had a higher risk of developing cerebral palsy, motor delay, and coordination disorder. Conclusion: LP had a higher risk of neurological impairments than FT infants, due to a brain immaturity and an increased vulnerability to injury, as the last weeks of gestational age are crucial for the development of the brain.


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