Subject: Child Neurology

Series: Mac Keith Press Practical Guides

Publication date: 01/01/2010

ISBN: 9781898683698

Edition: 1st

Pages: 404

A Handbook of Neurological Investigations in Children

Mary King, John Stephenson (Authors)

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Neurological disorders in children are common: families want to know what is wrong, why it happened, and whether it will happen again. Management and treatment depend on establishing the diagnosis, which usually requires investigations, but the number of possible neurological investigations is now very large indeed, and uncritical investigations may be seriously misleading and often costly.

This book, based on the authors’ vast combined personal experience, gives practical guidance on how to target any specific condition with the minimum of tests.

  • Part 1 is a brief distillation of advice on clinical history and examination, introducing the problems that beset those who deal with neurological disorders in childhood.
  • Part 2 outlines the investigations available to solve these diagnostic problems.
  • Part 3 takes a problem-oriented approach to the most appropriate investigations in the various clinical scenarios that may present to the practitioner: the starting point is the patient’s presentation, not the diagnosis.

Throughout, vignettes of real cases help to illustrate the use of the tests in different clinical situations.

The authors co-wrote the hugely popular Handbook of Neurological Investigations (‘the Blue Book’) 20 years ago. This new book, while closely following the highly successful approach of the earlier title, is thoroughly up to date, with fresh material, new case vignettes, and additional investigations covered.

A Practical Guide from Mac Keith Press

Mary King

Consultant Paediatric Neurologist, Children’s University Hospital, Dublin, Ireland

John Stephenson
Honorary Professor in Paediatric Neurology and Senior Research Fellow, Division of Developmental Medicine, University of Glasgow, UK

Authors viii
Acknowledgements ix
Foreword xi
Rob Rust
Abbreviations xiii
Introduction 1
Part 1
1.1 History Highlights 7
1.2 Examination Essentials 11
Part 2. Investigations
2.1 Video with Audio 14
2.2 Electroencephalography 22
2.3 Electromyography and Nerve Conduction Studies 40
2.4 Evoked Potentials 49
2.5 Structural Imaging 55
2.6 Functional Imaging 85
2.7 Cerebrospinal Fluid 93
2.8 Cardiac Tests and Autonomic Function 105
2.9 Microscopic Examinations: Cells and Biopsies 112
2.10 Microbiology 123
2.11 Haematology 129
2.12 Immunology 134
2.13 Genetic Investigations 144
2.14 Biochemistry 151
2.15 Antiepileptic Drug Monitoring 198
2.16 Diagnosis by Clinical Trial 201
Part 3. Clinical Settings
3.1 Neonatal Seizures 208
3.2 Abnormal Neonatal Neurology 214
3.3 Delayed Development 223
3.4 Floppy Infant 228
3.5 Abnormal Head Size 235
3.6 Wobbly-eyed Baby 240
3.7 ‚Cerebral Palsy‚ 243
3.8 Peculiar Gait 251
3.9 Learning Disability/Mental Retardation 259
3.10 Speech and Language Disorders 265
3.11 ‚Psychiatric‚ Disorders 271
3.12 Epileptic Seizures and Epilepsy 275
3.13 Febrile Seizures 294
3.14 Paroxysmal Non-epileptic Disorders 297
3.15 Epileptic and Non-epileptic Disorders Together 305
3.16 Acquired Neurological Deficits 310
3.17 Acute Encephalopathy 318
3.18 Headache 327
3.19 Weakness and Fatigue 330
3.20 Ataxia 333
3.21 Movement Disorders 337
3.22 Progressive Loss of Skills and Dementia 344
3.23 Rare Treatable Disorders 355
Appendix 1. Predictive Value of Investigation Results 364
Appendix 2. Some Normal Values 368
Appendix 3. List of Clinical Vignettes 371
Index 373

This is easy to read, particularly because of the vignettes. I especially appreciate the examples that demonstrate how inappropriate investigations can lead to abnormal findings. In these instances, the findings had nothing to do with the underlying diagnoses and sometimes ended poorly due to the missed diagnoses. These cases underscore the authors' contention that the history and examination (sometime over multiple visits) with appropriate use and interpretation of investigations should remain the cornerstone of pediatric neurology.'

Korwyn Williams, MD, PhD, Phoenix Children's Hospital

'..a very readable and thought-provoking book. The very individual approach adopted towards investigation of neurological disorders has made the subject very tangible for general paediatricians...The book is essential reading for all paediatricians, especially those in training, and the odd paediatric neurologist might consult it.'

B M MacArdle, Archives of Diseases in Childhood

This handbook is highly recommended to all those attempting to master child neurology, whether they are just starting their training or nearing retirement.'

Robert J. Baumann, Pediatric Neurology, 2010

Twenty years is a long time to wait between editions of a book but in this case the wait has been worth it. Both authors will be well known to readers of this journal and not surprisingly have produced a book that is a pleasure to read and substantially different from the first edition.'

Philip E. Jardine, European Journal of Paediatric Neurology, 2010

'I believe A Handbook of Neurological Investigations in Children is an extremely valuable reference for all clinicians and allied health professionals who are involved in the care of children with neurological disorders. It provides an excellent overview on investigating such children in order to try and determine a diagnosis. This practical guide undoubtedly fulfills its aim.'

Rajat Gupta, Developmental Medicine & Child Neurology, 2010

A Handbook of Neurological Investigations in Children – Chapter 1.1: History Highlights & 1.2: Examination Essentials (free ebook) - £0