Description

The four-week rotation is designed to provide the student with an understanding of the basic principles of child neurology, including history taking and examination, knowledge of common presenting symptoms and signs, an overview of neurological disorders in childhood, and essentials of diagnosis and management.

Specific goals

1. Demonstrate an understanding of the presenting signs and symptoms and management of neurological problems seen in children and adolescents, including:
   • Migraines
   • Seizures, including febrile seizures
   • Sleep disorders
   • Motor and vocal tics and Tourette syndrome
   • Neuromuscular disorders and muscle weakness
   • Hydrocephalus
   • Central nervous system (CNS) tumors
   • Ataxia
   • Myelodysplasia
2. Demonstrate proficiency in eliciting the neurological history and performing the neurological examination of infants, children and adolescents
3. Develop increasing sophistication in interpreting clinical findings and synthesizing them into a rational differential diagnosis
4. Demonstrate an understanding of the indications for neuroimaging in children with neurological symptoms or signs (or both) and recognize structural abnormalities on images of the brain and spinal cord
5. Develop an increased understanding of the selection of appropriate laboratory tests (both sequence and nature) necessary to establish a specific diagnosis
6. Gain an increased understanding of management principles, including the indications for use, risks, benefits and potential side effects of pharmacological interventions for headaches, seizures, tics, sleep disorders, dystonia and movement disorders
7. Evaluate and manage many common and emergent neurological problems, including common neurological emergencies:
   • Coma
   • Status epilepticus
   • Bacterial meningitis
   • Acute viral meningoencephalitis
   • Acute or subacute progressive, generalized weakness
   • Acute paraplegia
   • Initial management of closed head injury
   • Brain herniation syndromes
   • Acute ataxia
   • Acute intoxications
8. Develop the ability to lucidly discuss the evaluation and management of children with seizure disorders, intellectual disability, learning disorders, intracranial masses, primary muscle problems, spinal cord disorders and peripheral nerve disease

Activity outline

Students attend hospital rounds, supervised outpatient experiences, and both clinical and didactic neurology and pediatric conferences. In addition to regular patient interviews and physical examinations, students are expected to outline an appropriate plan of laboratory investigation and management.

Whenever possible, more-intensive searches of patient records and an analysis of a series of patients are encouraged with the possibility that the activity may lead to further pursuit of the subject. Becoming familiar with the literature and informed about salient features of disease processes, including physiological and biochemical aspects, is encouraged.

Conference schedule

Monday

12:15 to 1 p.m. — Neurology Grand Rounds

Tuesday

12:15 to 1 p.m. — Neurology Case Conference (twice monthly)

Wednesday

12:15 to 1 p.m. — Child Neurology Conference (one journal club a month)

Thursday

None

Friday

Noon to 1 p.m. — Neurology Subspecialty Conference

Method of evaluation

Close interaction with residents and consultants on the service is the primary source of evaluation. Evaluations are completed through MedHub.