Pediatric neurologist. Symptoms and diseases for which you should visit a doctor. When is it necessary to contact a pediatric neurologist? What should a baby complain to a neurologist about?

A neurologist is a doctor who must monitor the health of your child at each stage of development, give advice on how to properly care for the baby, and treat if the child is sick. A visit to the doctor is necessary almost every month.

An examination is mandatory even if the baby is absolutely healthy, especially since this may not be the case. Only a specialist can identify deviations from the norm. An examination is carried out once a quarter, since the status of the newborn changes almost every month. Each segment is marked by the formation of some skills; this happens due to the continuous growth and development of the body.

In the maternity hospital

When the mother and baby are discharged from the maternity hospital, the baby undergoes ultrasonography of the brain. Brain cysts are a common diagnosis in newborns. Why this pathology occurs is not completely known to medicine. If the tumor size is no more than 5 mm, then there is no reason to worry, and the tumor will resolve by three months. If a cyst has been detected, then it is necessary to monitor the dynamics of its development every month.

The causes of central nervous system disease are:

1. Pathological pregnancy;
2. Complications during childbirth;
3. Congenital infections;
4. Injuries, prematurity.
5. You should not postpone examination by a neurologist if you notice:
6. Restless sleep;
7. Regurgitation and vomiting syndrome;
8. Tremor of the arms, legs and chin;
9. Paroxysms of varying duration.

Let's take a closer look at what a neurological examination is like at each stage of life.

Upon reaching one month

At one month, during an examination, the neurologist pays attention to the child’s reflexes and posture. At one month of age, innate reflexes are most obvious.

The neurologist pays attention to the condition of the muscles, since newborns are characterized by hypertonicity, the position of their body is similar to what it was in the womb: the baby draws in his legs, clenches his fists.

The muscles should be symmetrical on both sides. Different muscle tone indicates the presence of pathologies. A newborn is able to stretch after sleep when he is one month old.

The body movements of a small person are chaotic and disorderly. In the first month of life, the baby begins to focus on an object, examines it carefully, and is even able to follow its movements.

If the baby can hold his head up at two weeks, this indicates intracranial hypertension, which is treated by a doctor. During this period, the child begins to express emotions, for example, smiling when hearing his mother’s voice. It is absolutely impossible to ignore visiting a neurologist at this age.

The head circumference reaches 35 cm. In the first month, it is important to monitor growth dynamics. Every month the circumference should increase by one and a half cm. The neurologist pays attention to the condition of the fontanel.

Upon reaching three months

At this stage, the baby learns to use his hands. The baby begins to study them, putting his fingers in his mouth. By three months, the newborn’s reflexes practically disappear, as the cerebral cortex begins to be responsible for regulation. The grasping reflex is replaced by conscious grasping of objects.

A three-month-old baby should be able to hold his head upright. If this does not happen, then the child is likely to have delayed physical development or. This will be revealed during the examination.

At this age, an emotional-motor reaction directed towards an adult appears. It occurs during communication or when a new object comes into view. Children's laughter is heard more and more often in the house. The tone and tension of the flexors decreases, postures become more relaxed.

At six months of age

During this period, the neurologist looks at the child’s skills during the examination. At six months, the baby should be able to roll over onto his back and stomach, raise his head, and lean on his elbows.

The child begins to recognize his parents and distinguish them from other people. The reaction to strangers is completely unpredictable: from a smile to strong crying.

At six months, the baby is able to perform simple manipulations with toys, for example, transferring an object from one hand to another. Body movements gain precision and confidence. Emotional reactions become less monotonous, the child begins to try to repeat simple combinations of sounds.

After six months, the head circumference increases by one cm. There are attempts to assume a sitting position, even with the help of adults.

Older children

During the examination, the neurologist pays attention to the baby’s ability to sit without support and evaluates physical development. Children at this age begin to crawl and stand up.

As for fine motor skills, the child is already able to hold an object with two fingers. The child parodies the movements of adults: waves his hand, claps his hands. The baby knows well who his mom and dad are and is wary of strangers. The baby understands that this is impossible, can find the desired object among others, and understands the meaning of the spoken words.

An examination at one year of age cannot be ignored, because the baby begins to become a full-fledged person. At the age of one year, many children are already able to move independently, some take their first steps holding a parent’s hand.

In the year and third month, every healthy child should be able to walk. The ability to sit at the table becomes better: the baby holds cutlery, eats with them, and knows how to drink from a mug.

The development of the cognitive sphere occurs by leaps and bounds: the child knows the names of objects, parts of the human body, and the sounds that animals make. By this time, the head circumference increases by ten cm.

The most common questions parents ask a neurologist

What causes constant tension in the limbs?

Hypertonicity is a normal phenomenon inherent in all newborns up to a certain age. Babies bend their arms, press them to their chest, clench their fingers tightly into a fist, and the thumb lies under the others. The lower limbs are also bent, but less than in the arms.

Dads and moms may notice that the tone changes; if you turn your head to the left or right, the muscle tone will become higher on one side. This feature of the child's body is called. But don’t be afraid of medical terminology; this condition is considered absolutely normal.

By four months, muscle tone becomes less and less, and many muscle groups are used when moving. Hypertonicity cannot be treated in any way, but it is permissible to do a massage that promotes the harmonious development of the body. Advice on how to do a massage should only be given by a qualified specialist. During the examination, the doctor will tell you if there is cause for concern.

Is tremor of the limbs and chin a sign that the child is cold or something wrong with the nervous system? Is it necessary to visit a doctor?

Trembling in the body, or scientifically called tremor, occurs in the first stages of life. The reason for this is the incompletely formed central nervous system. Tremor occurs due to emotional shock, physical stress, but sometimes the attack begins suddenly. Trembling can occur on both sides or on one. Young mothers worry in vain when they notice trembling in the child’s body. If the tremor repeats periodically, each time becoming longer and more intense, then this is a reason to go to an appointment with a neurologist.

What is the sucking reflex? Why does a child constantly suck something: fingers, a pacifier, a breast? Maybe he's hungry?

The sucking reflex is one of the main ones in children under one year old; it is innate. Any irritation of the mouth causes sucking movements in the newborn. The reflex ceases to manifest itself when the child reaches four years of age. In infants, there is a search reflex, as well as a proboscis reflex. While eating, these reflexes intensify, but this does not mean that the child wants to eat.

Why does the child twitch and throw his arms to the sides? Is it necessary to see a neurologist?

This behavior of the child is explained by the Mohr reflex. It persists for up to six months and often occurs when changing body position or loud sounds. If you pick up a baby from the crib and then put it back, the baby will involuntarily raise his arms up. Sometimes the Mohr reflex occurs involuntarily or as a response to knocking, screaming or clapping. Such hand movements are common to all babies; it is not their presence, but their absence that should cause concern. But upon reaching 5 months, the reflex should disappear.

What causes frequent regurgitation? Is there a need to seek help from specialists?

Regurgitation up to five times a day is the norm, not a neurological disorder. This is especially common in the first month of life. is associated with the structural features of the gastrointestinal tract and its functioning: the ventricle is located horizontally, has the shape of a circle and a very small volume, no more than ten mm. Therefore, babies can fill up on small amounts of milk. The cardiac sphincter of the stomach is small in size, and the entrance to the stomach has a larger diameter. Because of this, food moves slowly through the gastrointestinal tract.

Regurgitation is also promoted by:

• Excessive amount of food;
• Prematurity;
• Underweight;
• The breathing process is still imperfect;
• Lack of digestive enzymes;
• Swallowing air while eating;
• Short intervals between feedings.

What is that white line on the baby's eye? Why does she appear?

This phenomenon is called Graefe syndrome. The presence of a stripe between the iris and the eyelid does not indicate the presence of any pathologies; it occurs quite often in newborns.

It occurs due to changes in body position, changes in lighting, and simply due to the individual characteristics of the body. The immaturity of the nervous system also contributes to its formation.

Graefe's symptom goes away on its own within six months. But if the symptom is accompanied by strabismus, high excitability, mental retardation, then you should immediately visit a neurologist for an examination.

Why does a child hit his head?

Small children sometimes start banging their heads against objects around them. Scientists do not fully know what causes head shaking in children under 3 years of age. It is believed that in this way babies train the vestibular apparatus and calm down. You've probably noticed that shaking your head ends up falling asleep.

Sometimes children bang their heads to attract attention and express protest. In psychology, this syndrome is called “self-punishment.” A child hits his head so that mom and dad will feel sorry for him. Such behavior can be avoided if direct prohibitions are not made. To prevent head banging from causing serious physical harm, you should remove dangerous objects away from the baby.

Medicines prescribed by a neurologist

The mixture often contains motherwort and valerian, which are famous for their calming properties. But reviews indicate that you should be careful with these plants, because they very strongly depress the nervous system. The mixture contains:

• Diphenhydramine;
• Glucose;
• Purified water that does not have any impurities;
• Sodium bromide.

Doctors prescribe medications containing Magne B6 to children. Reviews from moms and dads indicate that these medications have a beneficial effect on the baby’s fragile nervous system. If a pediatric neurologist has prescribed Magne B6 for a newborn, keep in mind that it has a laxative effect.

The doctor whose visit instills fear in most Russian parents is a neurologist. Moms and dads are afraid that this particular specialist will definitely find some kind of neurological abnormality in their beloved child. And these fears are not so groundless - according to statistics, 90% of children in our country have one or another neurological diagnosis. The famous children's doctor Evgeniy Komarovsky tells parents whether this diagnosis is always reliable and whether neurological problems are really that common.

Features of the children's nervous system

The nervous system of a newborn undergoes the most significant changes during growth. Children are born with an immature nervous system, and it has yet to form and strengthen. The most intense changes occur during the neonatal period and the first year of life, and therefore it will not be difficult for any neurologist to find certain neurological symptoms in a baby at 2 months or 6 months.

During the period of formation of the functions of the nervous system, not everything goes smoothly, says Evgeny Komarovsky, hence the incomprehensible cry for an incomprehensible reason, spasms and tics, hiccups and regurgitation, which bring so much worry to parents and rich food for the work of doctors.

If mothers understand the seriousness of the processes occurring with the child, questions, fears and doubts will become much less.

The brain of a newborn is quite large compared to the body; as the child grows, the proportions change, the structure of the brain becomes more complex, and additional grooves appear.

The most active changes occur in the period from birth to 5 months.

The spinal cord and spine of a baby grow unevenly, and their growth levels off only by the age of 5-6 years. The speed of transmission of nerve impulses in a child’s nervous system is different than that of an adult, and it will only come into line with mother’s and father’s by the age of 6-8 years.

Some reflexes that a newborn has go away over time and by the age of one year there is no trace left of them; they are replaced by permanent reflexes. The sense organs of newborns function from the first minutes after birth, but not in the same way as in adults. For example, a baby begins to see clearly at about 1.5-2 months, and he can hear well already on the third day after birth.

Neurological problems

When mothers complaining about their child’s trembling chin, shaking hands or regular hiccups come to the doctor, he understands perfectly well that in 99% of cases such symptoms are a variant of the norm, given the intensive process of improving the nervous system. The doctor knows that these little “troubles” will most likely go away on their own, and perhaps very soon. But he, according to Komarovsky, does not want to take responsibility for your child, and therefore it is easier for him to say that a shaky chin is a neurological symptom, and prescribe a certain treatment that will not cause harm (massage, swimming in an inflatable ring on the neck, vitamins).

Real neurological problems, of course, exist, and without exception they are all very serious, says Komarovsky, but they occur in only 4% of children.

Therefore, most of the neurological diagnoses made to children by neurologists in the clinic during the next routine examination have little in common with real diseases.

The worst thing is if the doctor prescribes medications to the child to eliminate neurological symptoms, which, by and large, exist only on paper.

Real situations when such pills are needed are no more than 2-3% of all established diagnoses. But everyone to whom they are prescribed takes them.

Komarovsky considers drug treatment to be effective only for children in the first month of life, if they actually have serious problems during childbirth. Then even they are only shown massage and physiotherapy.

When does a problem really exist?

- a diagnosis that Russian clinics love to give to children. Then, when it really is, the child needs urgent hospitalization, and not home treatment with pills, says Komarovsky. If a child is cheerful, alert, active, and sociable, there is no need to treat intracranial pressure, since with a high degree of probability there is none at all.

The most common complaint with which parents turn to a pediatric neurologist is the child’s pain.

In most cases, this is where the search for a disease begins, which will most likely be found.

Komarovsky urges mothers to stop looking for illnesses in their child and simply understand that a child has a lot of other reasons for crying - hunger, heat, the desire to communicate, the desire to attract attention, an uncomfortable diaper, and so on. All these reasons have nothing to do with neurological diseases.

Very active children are considered sick, they are immediately diagnosed with “hyperactivity”, calm and slow children are also considered unhealthy, they are labeled “lethargy”, and they try to explain poor sleep and appetite with neurological problems. There is no need to do this, says Evgeny Komarovsky, since real neurological diseases are rare, and they sound menacing; probiotics and gymnastics do not treat them.

These include epilepsy, cerebral palsy, neuroses of varying severity, Parkinson's disease, encephalopathy, pathological involuntary nervous tics and other conditions, many of which are congenital.

There is no need to compare your child with other children and the theoretical norms for the development of children. Your child is a personality that develops in accordance with its internal “settings”; they are purely individual.

The best prevention, and at the same time treatment of supposedly neurological “problems” that exist only on the doctor’s paper and in the heads of restless mothers and grandmothers, is the correct lifestyle of the child.

Long and regular walks, bathing, hardening, reasonable nutrition (without overfeeding), a daily routine that is convenient for mother and child, which is strictly observed, a strengthening massage every day, will help cope with hyperactivity, a trembling chin, and sleep disturbances in the child.

Be careful not to overdose on calcium and vitamin D, as these conditions can actually cause certain problems with the nervous system. You should talk about this in more detail with your treating pediatrician, who will determine the necessary dosages for your specific child, taking into account the age, weight and health status of the baby.

You will learn more about Dr. Komarovsky’s opinion on neurological problems in children from the following video.

If you are often tormented by causeless anxiety, you have become very nervous, you are unable to stay in stuffy rooms, you are prone to fainting, then you need to pay close attention to your health. Such complaints, even from light loads, are a reason to consult a neurologist.

Who is a neurologist

Before going to a medical institution, you need to understand who a neurologist is and what he treats. Both adults and children may need this doctor. A neurologist specializes in diseases of the autonomic system and disorders of the functioning of the nerves of the spinal cord and brain. He is engaged in careful consideration of complaints and subsequent treatment of identified diseases. This specialization can only be obtained by a person who has a diploma from a higher medical institution.

Among the diseases that this doctor treats are the following: neuralgia, tumors of the brain or spinal cord, neuritis, strokes, circulatory disorders, convulsions, head injuries, back injuries, sciatica, Alzheimer's disease, migraines, tremor in newborns, impaired concentration, motor disorders, mental disorders and others. Often, to stabilize the condition of such patients, it is necessary to involve a psychiatrist and psychotherapist.

What does he do?

A neurologist specializes in diagnosing and treating diseases related to the functioning of nerve fibers. It identifies the primary causes of diseases and their impact on a person’s overall well-being. A good doctor quickly and effectively prescribes competent treatment, which can significantly improve the patient’s quality of life. A neurologist who treats chronic fatigue is the most sought-after doctor in modern medicine.

Neurology is a science that studies the connection between the nervous system and human well-being. Neuropathology is the object of research and study of all neuroneurologists. Absolutely all diseases associated with impaired functioning of nerve fibers can be addressed to this doctor. Neurosurgery is a branch of surgery that deals with the surgical treatment of such diseases.

What diseases does a neurologist and neuropathologist treat?

Is there a difference between these specialties? In reality, a neurologist and neuropathologist treats diseases of the nervous system. It’s just that the term “neurologist” was used in the 80s of the last century. In domestic medicine, these concepts are identical. But in foreign practice, a neuropathologist specializes in the pathomorphology of the nervous system, and a neurologist deals with the identification and treatment of diseases of a nervous nature.

What's watching

A neurologist looks at the functioning of the nervous system. Performs an initial examination, checks unconditioned reflexes. The examination also includes a visual examination and palpation. The main task is to identify deviations in a person’s sensory or motor activity. If there are visible violations, he prescribes additional examination or treatment.

What tests does he prescribe?

When assessing the patient’s condition and to facilitate diagnosis of the disease, the neurologist prescribes tests. To accurately determine the disease, a vision or hearing test may be necessary. A specialist may prescribe the following types of tests:

• general blood analysis;
• Doppler ultrasound of the neck, head;
• electroencephalography;
• Brain MRI;
• electroneuromyography.

What complaints are addressed to a neurologist?

This doctor establishes a cause-and-effect relationship between the nervous system and the pathological condition and prescribes treatment. Sometimes you just need to adjust a person’s lifestyle to achieve the desired effect. An abundance of stressful everyday situations and poor environmental conditions are important factors in the manifestation of neurological diseases. The most common complaints that people come to a neurologist with are:

• fast fatiguability;
• frequent dizziness;
• poor concentration;
• constant bad mood;
• behavioral disorders;
• mental disorders;
• sleep quality disorders;
• constant feeling of fear and anxiety.

What symptoms do you see a neurologist for?

The most important thing is to detect early symptoms in yourself, this will prevent the development of serious diseases. A combination of negative factors affecting a person can aggravate the situation if they do not contact a specialist in a timely manner. A neurologist is consulted with symptoms such as:

• regular headaches;
• soreness in the chest on the left;
• fluctuations in blood pressure;
• increased nervousness;
• migraine;
• disturbances in the functioning of the sweat glands.

What problems are being addressed?

The reasons for visiting a neurologist are a deterioration in a person’s quality of life. Chronic fatigue and overexertion in everyday life causes disorders of the cardiovascular system. And this brings with it hypotension (low blood pressure), hypertension (high blood pressure). It is fraught with the development of various metabolic disorders. The most important thing is to consult a doctor in time for help. The specialist will prescribe professional therapy and medication.

A very important specialist is a pediatric neurologist who deals with problems of the central and peripheral nervous system in patients from birth to 18 years of age. According to statistics, every fifth child has functional or organic problems with the central nervous system, which require consultation with a neurologist. Preventing the progression of nerve pathologies in children allows us to avoid irreversible disorders that will significantly reduce the quality of life.

A pediatric neurologist must be a good and competent specialist in his field in order to effectively diagnose and treat relevant pathologies. In children, the nervous system is not perfect for a long time and continues to develop until adulthood, requiring attentive support. A missed pathology can cause disability, but rarely leads to death.

When to contact a pediatric neurologist?

Parents should know what a pediatric neurologist treats and when to seek help. In childhood, when the child’s socialization is in a state of active development, and this process occurs individually, it is difficult to notice any problems in the neurological area. Parents should be alert to the following symptoms, which are a reason to contact a neurology clinic:

• increased excitability of the child, which is manifested by poor falling asleep, shallow sleep, constant awakenings and moodiness;
• for newborns, the neurologist notes a special symptom: trembling of the limbs and head during crying or anxiety;
• frequent, unmotivated regurgitation;
• apathy of the baby, lack of interest in the surrounding reality;
• convulsive syndrome during fever of any origin;
• frequent headaches in older children (in children the subjective symptom cannot be determined in any way, so you should pay attention to the general condition and mood of the child);
• fainting (two or more times within a certain period of time);
• involuntary twitching of muscles of different groups;
• excessive motor activity (it is difficult to assess this on your own, so a pediatric neurologist checks for deviations from the norm using various tests);
• developmental delay in the first year of life, which should be reported to the pediatrician;
• enuresis after the age of 5-6 years;
• stuttering and other speech defects.

Do children need preventive examinations?

In babies under 12 months of age, the pediatrician looks for various deviations from the norm every 4 weeks.

The need for such an approach is due to the fact that parents will not be able to independently assess the physiology of the baby’s development and notice pathological changes in time.

The same situation is with a pediatric neurologist, who is recommended to visit during the following periods:

• one month after birth;
• at 3 months;
• in six months;
• after reaching one year of age;
• at 4-5 years old (pre-school period);
• at 7 years old (junior school);
• at 13-14 (teenage).

A pediatric neurologist monitors the formation of the nervous system until adolescence, where serious hormonal changes occur. Preventive examinations with this doctor allow you to notice violations early and not lead them to a severe course. Besides, a neurologist can detect psychomotor underdevelopment in time or intellectual retardation.

How does an appointment with a specialist work?

At an appointment with a pediatric neurologist, the following things are checked:

• visual reflexes;
• muscle tone and strength;
• coordination;
• superficial and deep reflexes;
• sensitivity disorders;
• development of cognitive functions (speech, memory, etc.).

Additionally, general laboratory tests and specific instrumental techniques may be prescribed, for example, EEG, MRI, ultrasound with Dopplerography of cerebral vessels and others.