For parents’ information

Calendar, with which we compare our life, schedule vacation, wedding, housewarming, school entering, its graduation is not suitable for all occasions. There exists much more important one for us – an individual calendar.

Its duration is 40 weeks, 9 months – from impregnation to birth. Parental intervention into the “antenatal calendar” begins yet with the moment of fertilization. Any external influence, voluntary or involuntary, can strike with a serious illness of an unborn child. Especially careful should be the supercritical period, during the stage of body anlage. The first 12 weeks of pregnancy are also called the “teratogenic calendar.”

Every organ, every body system has its own critical period of development, when the influence of pathogenic factors is the most dangerous. The most vulnerable period falls on the 6th – 7th day after conception, when the young embryo penetrates into the endometrium. By the fourth month of pregnancy the placenta is finally formed. This is another very vulnerable period of time. And the most important thing for the future life falls on the period between these two moments, from the 18^th  to 84^th  day of intrauterine development. These days the brain, limbs, eyes, heart, lips, teeth, ears, pharynx, and internals are formed. These features need to be known to future parents, so that the bitter cup shies away from their child.

Let us briefly list the main infant’s symptoms necessary for consulting a pediatric neurologist:

• if the child sucks weakly, takes breaks, gets tired at the same time. Chocking and the milk flow through the nose have been observed;
• if the child has a weak cry, and the voice has a nasal shade;
• if the newborn often vomits, insufficiently puts on weight;
• if the child is inactive or, on the contrary, too restless, and this anxiety is aggravated even with the minor environmental changes;
• if the chin and also upper or lower extremities tremors have been observed, especially when crying;
• if a child often covers without reason, falls asleep with difficulty, and the sleep is shallow, short in duration;
• if the child constantly throws back his head, lying on the side;
• if fast or, on the contrary, slow growth of the head circumference is registered;
• if the child’s physical activity is reduced, or he/she is very sluggish, and the muscles are flabby (low muscle tone), or, conversely, the child is constrained in movement (high muscle tone), so that swaddling is difficult;
• if one of the limbs (arm or leg) is less active in movement or is in an unusual position (clubfoot);
• if the child skews or opens his/her eyes wide, a white sclera band is periodically visible;
• if the baby is constantly trying to turn his/her head in one direction only (torticollis);
• if the dilution of the hips is limited, or, conversely, the child lies in a frog pose with the hips spread 180 degrees;
• if the child is born by caesarean section or in pelvic presentation, if obstetric forceps were used at birth, if the baby was born prematurely or with heavy weight, if cord entanglement was noted, if the child had convulsions in the maternity hospital.

One year old children should consult a pediatric neurologist in the following cases:

• difficulty in falling asleep;
• early-life failure of daytime sleep;
• restless night’s sleep, long sleep;
• fast switching of attention (from 1-2 years of age);
• high distractibility, difficulty in concentrating, difficulties in communication and learning (preschool and primary school age);
• late speech development (lack of simple phrases of two words at the age of 2);
• deep excitement (from 2 years);
• tearfulness, fatigue, moodiness, increased demands for attention, attacks of ungrounded crying (especially at night);
• frequent falling, stumbling, uncertain gait (from 1.5 years);
• tiptoe walking (after 1 year);
• abdominal pain, loss of appetite;
• headaches;
• bedwetting;
• twitching with rising temperature (convulsions)

Obligatory periodic check of children during the 1st year: at the age of 1 month, 3 months, 6 months, 12 months, or individually by doctor’s prescription. During the 1st year of age the brain neurosonography with an assessment of blood flow speed through the major head vessels is the must.

In adolescence one should visit the neurologist in case of the following neurological disorders:

• Backache
• Headache, dizziness, fainting
• Sleep disturbances and irritability
• Peripheral nerve diseases (neuralgia, neuropathy)
• Memory and attention disorders
• Rapid fatigability
• Speech development, sound pronunciation, and writing delays
• Reduced vision and transient visual disturbances
• Nosebleeds
• Traumatic brain injury

If your child was in follow-up by a neurologist during the first year of life, it is worth visiting the doctor again at the age of 4 and 8. These are critical stages for the the central nervous system development. If your child had no problems for a year, then you should visit a neurologist before going to school and in adolescence.

The neurologist’s examinations are of great as they allow to identify the central nervous system abnormalities and assign the appropriate diagnostic measures and treatment in due time.