AANN Core Curriculum, 7th Edition, Ch. 26 Pediatric and Developmental Disorders: Digital Version-Chapter 26

Chapter 26

Pdf Summary

This chapter reviews neurological disorders arising in neonates and children, emphasizing early recognition, age-appropriate assessment, timely treatment, and family support to reduce lifelong effects.<br /><br />Neonatal evaluation includes prenatal and birth history, vital signs, head shape and circumference, tone, spontaneous movement, cranial nerve function, and gestational-age-appropriate reflexes. Premature infants are especially vulnerable to germinal-matrix and brain hemorrhage, white- and gray-matter injury, hydrocephalus, cerebral palsy, seizures, and cognitive impairment. Neonatal seizures may result from hypoxia–ischemia, hemorrhage, infection, stroke, metabolic disturbances, genetic conditions, or drug exposure; EEG and imaging help guide treatment. Hypoxic–ischemic encephalopathy ranges from mild symptoms to coma and severe neurological injury. Therapeutic hypothermia can reduce death and major developmental consequences in eligible infants.<br /><br />Developmental delay and intellectual disability have diverse causes and require medical and developmental evaluation, early therapies, seizure management when needed, and coordinated family and community support. Congenital brain malformations may cause hydrocephalus, seizures, feeding difficulties, and long-term disability.<br /><br />Craniosynostosis is premature fusion of skull sutures and may require surgery; positional plagiocephaly results from sustained pressure on the skull and is usually managed with repositioning, supervised tummy time, and, in selected cases, a molding helmet. Neural tube defects range from occult spinal abnormalities to visible myelomeningocele. Care may include prompt closure, protection from infection, monitoring for hydrocephalus and urinary complications, and long-term rehabilitation. Folic acid before and early in pregnancy helps prevent open defects.<br /><br />Chiari malformations can obstruct cerebrospinal fluid flow and cause headaches, neurological symptoms, or syringomyelia; symptomatic cases may require posterior fossa decompression. Syringomyelia management addresses its underlying cause and monitors neurological function. Pediatric brain tumors present variably according to location and may cause headaches, vomiting, seizures, gait or vision changes, developmental regression, or endocrine problems. Treatment commonly combines surgery, radiation, and chemotherapy, followed by monitoring for long-term effects.

Keywords

neonatal neurological disorders

premature infants

neonatal seizures

hypoxic-ischemic encephalopathy

developmental delay

intellectual disability

craniosynostosis

neural tube defects

Chiari malformations

pediatric brain tumors