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This Article Full Text Full Text (PDF) Take the CME quiz: Vol. 18 No. 6, June 1997 Rapid Responses: Submit a response Alert me when this article is cited Alert me when Rapid Responses are posted Alert me if a correction is posted Services E-mail this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My File Cabinet Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Craig Morriss, M. Articles by Zimmerman, R. A. Search for Related Content PubMed PubMed Citation Articles by Craig Morriss, M. Articles by Zimmerman, R. A. Related Collections Neurologic Disorders

(Pediatrics in Review. 1997;18:192-203.)
© 1997 American Academy of Pediatrics

Neurodiagnostic Techniques

M. Craig Morriss, MD^*
Douglas J. Hyder, MD
Robert A. Zimmerman, MD

^* Fellow in Pediatric Neuroradiology.

Fellow in Pediatric Neurology.
Professor of Radiology, Department of Neuroradiology, The Children's Hospital of Philadelphia and the University of Pennsylvania School of Medicine, Philadelphia, PA.

	IMPORTANT POINTS

 

1. Common pediatric neuroimaging procedures are: 1) computed tomography (CT), 2) magnetic resonance imaging (MRI), and 3) ultrasonography (US). Common neurophysiologic tests include: 1) electroencephalography (EEG), 2) electromyography (EMG), 3) brainstem auditory evoked potentials (BAER), and 4) visual evoked potentials (VER).
   
2. CT is a rapid screening test for emergencies, particularly when looking for intracranial hemorrhage or in cases where bone detail is needed. MRI is useful in imaging soft-tissue lesions such as tumors, malformations, phakomatoses, or the spine. US is useful for screening for neonatal brain injury or malformation, but may require a more definitive follow-up test such as MRI if an abnormality is identified.
   
3. Limits of neuroimaging modalities include: insensitivity to subtle parenchymal lesions, bone artifact in the posterior fossa, and exposure to ionizing radiation for CT; insensitivity to subarachnoid hemorrhage, lack of fine bone detail, inaccessibility to patients during scanning, and lack of availability for MRI; and skill of examiner, conspicuity of superficial cortex and brainstem lesions, and ages when scanning can be performed (infants and neonates) for US.
   
4. EEG is indicated to evaluate the cerebral cortex to clarify cerebral activity during clinical events suspected to be seizures, sleep disturbance, acquired aphasia, headache, or coma. Mass lesions, cerebral dysgenesis, central nervous system (CNS) infection, or CNS degenerative disease also cause abnormal EEGs, but the diagnosis is secured with neuroimaging tests.
   
5. EMG is indicated when disease of the peripheral nerves, neuromuscular junction, or muscle are suspected.
   
6. BAER and VER are most useful for evaluating hearing and vision in infants.
   

Evaluation of children who have neurologic disorders combines clinical examination with neurodiagnostic procedures. New and emerging technologies have improved remarkably the ability to diagnose complex neurologic disorders. Both functional and anatomic information can be derived from magnetic resonance images (MRI) of the brain, providing useful correlative information to traditional neurophysiologic tests . . . [Full Text of this Article]