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Newborn Neurologic Exam
Aka: Newborn Neurologic Exam
- See also
- Newborn Head and Neck Exam
- Craniosynostosis
- Head Circumference
- Fontanelle
- Dysraphism (Neural Tube Defect)
- Intraventricular Hemorrhage in Preterm Infants
- Exam: General
- Newborn Reflexes
- Primitive Stepping Reflex
- Rooting Reflex
- Moro Reflex (Startle Reflex)
- Babinski Reflex
- Upgoing toe until after 6 months of age
- Seizures
- See Neonatal Seizures
- Typically subtle in infants (e.g. lip smacking, repetitive movements)
- Posture
- Normally in Fetal Position with hands closed
- Hold infant in vertical suspension
- Hypotonia is this position is abnormal
- Alertness
- Awakened by uncovering or stimulating foot or cheek
- Level of activity
- Jitteriness
- Normal fine Tremor provoked when startled
- Consider Electrolyte abnormality if severe (obtain Serum Glucose, Serum Magnesium, Calcium)
- Consider Drug Withdrawal for infants of mothers on longterm medications of drugs (e.g. Methadone, SSRI)
- Benign neonatal sleep Myoclonus
- Myoclonic Jerks while sleeping (resolves when infants are awake)
- Presents at 2-4 weeks of life, and resolves by age 6 months
- Saccadic Intrusions
- When infants are tracking with their eyes, their eyes may make corrective jumps
- Small amplitude conjugate interruptions (not Nystagmus)
- Resolve over the first few months of life
- Differentiate from randomly wandering eye movements (may be a sign of blindness)
- Periodic breathing
- Common and normal in children
- Pauses in breathing up to 20 seconds are normal (unless associated bradycardi, mental status change, Skin Color change)
- Exam: Cranial Nerve Exam
- Pupil reflex
- Cranial Nerve II
- Doll's Eyes
- Cranial Nerve III
- Cranial Nerve IV
- Cranial Nerve VI
- Corneal, sucking, and Rooting Reflexes
- Cranial Nerve V
- Cranial Nerve VII
- Response to noise
- Cranial Nerve VIII
- Gag Reflex
- Cranial Nerve IX
- Cranial Nerve X
- References
- Drapkin (2019) Am J Emerg Med 37(6):1153-9 +PMID:30952605 [PubMed]
- Lewis (2014) Am Fam Physician 90(5): 297-302 [PubMed]