Child or adolescent neurological consultation at Western Neurological Associates in Utah

Child/Adolescent Neurological Consultation

The purpose of a neurological consultation is to allow the neurologist to gather information about the child's or adolescent's condition so the neurologist can diagnose the problem and plan a treatment. Going to see a doctor can be a frightening experience for a younger child, especially if the child is worried that something may be wrong. At Western Neurological Associates, great care has been taken to create a child-friendly environment so the experience will be as comfortable as possible.

Gathering Information

Paper work, including a four-page medical history, will need to be filled out by the parent or guardian accompanying the child or adolescent to the appointment. When the forms have been completed, the midlevel provider working with Dr. Michael L. Goldstein, will take the patient and his/her parent(s) to the exam room. The midlevel provider interviews the parent and child to obtain the following information:

History of present illness: Location, quality, severity, duration, timing, context, modifying factors, associated signs and symptoms.
Past medical history: Allergies, current medications, surgeries, injuries, other.
Social history: School, family members, habits
Family history: Parents, other.
Review of systems: Constitutional (fever, weight loss, etc.), eyes, ENT, cardiovascular, musculoskeletal, respiratory, GI, GU, skin, endocrine, other.

After the interview is finished, the exam follows. A child/adolescent is rarely asked to put on a patient gown. The exam covers the following areas:

Physical exam: Blood pressure sitting/standing, blood pressure lying, pulse, respirations, height, weight, general appearance, cardiovascular (carotids, heart, and peripheral).
Mental status testing: Age-appropriate exam based on the Denver Diagnostic Exam.
Neurological exam/cranial nerves: Ophthalmoscopic, pupils and eye movements, facial sensation, facial strength, hearing, palate, shoulder shrugs, tongue.
Remaining neurological exam: Sensation, reflexes (Babinski), coordination, gait and station, muscle strength, muscle tone.

Diagnosis and Treatment

At this point, the midlevel provider will leave the exam room to discuss all of the information with Dr. Goldstein. Dr. Goldstein will then see the child or adolescent and ask any further questions he feels might be helpful and may repeat pertinent parts of the exam. He will then go over with the parent and the child his plan for treatment and/or testing. Tests often used by neurologists to help assess a patient's condition include CT and MRI imaging, EMG/NCV tests, and EEG testing.

Child neurologists treat medical conditions such as headaches, neck pain, back pain, arm and leg numbness and tingling, seizures, concussions, sport's related injuries, developmental delays, and attention deficit hyperactivity disorder. Diseases diagnosed and treated by child neurologists include epilepsy, multiple sclerosis, muscular dystrophy, and cerebral palsy.

Medical Records

All of the information collected during the neurological consultation, including the physical and neurological examinations and the doctor's plan for treatment and/or testing, will be dictated onto a tape. The tape will then be transcribed into a formal report of findings and placed in the patient's chart for future reference.