López-Pisón J, Baldellou A, Rebage V, Arana T, Lobera M P, Peña-Segura J L
Sección de Neuropediatría, Hospital Miguel Servet, Zaragoza, España.
Rev Neurol. 1997 Dec;25(148):1905-7.
Diagnosis in neuropediatrics requires a detailed personal and family history and thorough physical examination. In this paper we study the psychomotor development and physical examination of children evaluated during a 5 year period, from May 1990 to May 1995 by a neuropediatrician newly appointed to the Hospital Miguel Servet in Zaragoza, which previously did not have such a specialist.
Psychomotor retardation was seen in 19% of the children. In 50% of the children evaluated, significant data was obtained from the physical examination. The commonest finding, observed in 14% of the children, was of anomalous behaviour or an impression of mental deficiency. In decreasing order of frequency other data were: Diffuse pyramidal involvement, cranial nerve involvement, anomalous phenotype, microcephaly, microsomy, signs of neuromuscular involvement, hemiparesia, macrocephaly, skin markings, scoliosis, signs of extrapyramidal involvement, signs of cerebellar involvement, macrosomy and sensory disorders.
Diagnosis in neuropediatrics is directed or established, sometimes exclusively, by an extensive personal and family history and adequate interpretation of this, which in the end depends on the skill of the clinician.
神经儿科的诊断需要详细的个人及家族病史以及全面的体格检查。在本文中,我们研究了1990年5月至1995年5月期间,由新任命到萨拉戈萨米格尔·塞尔维特医院的神经儿科医生对儿童进行评估的精神运动发育情况及体格检查。此前该医院没有此类专科医生。
19%的儿童存在精神运动发育迟缓。在接受评估的儿童中,50%通过体格检查获得了重要数据。最常见的发现(在14%的儿童中观察到)是行为异常或智力缺陷的印象。按出现频率递减顺序排列的其他数据为:弥漫性锥体束受累、脑神经受累、异常表型、小头畸形、身材矮小、神经肌肉受累体征、偏瘫、巨头畸形、皮肤斑纹、脊柱侧弯、锥体外系受累体征、小脑受累体征、身材高大及感觉障碍。
神经儿科的诊断有时完全由详尽的个人及家族病史以及对其的恰当解读来指导或确立,而这最终取决于临床医生的技能。