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Neuro testing for toewalkers

Discussion in 'Pediatrics' started by Jaimee Brent, Apr 18, 2013.

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  1. Jaimee Brent

    Jaimee Brent Active Member


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    Hi,
    I've had a few idiopathic toe walkers this year and have had conversations about possible neurological in put.
    Apart from refering to a neurologist, what sort of neuro testing would ypu first look at performing in clinic???

    Thanks

    Jaimee
     
  2. Admin2

    Admin2 Administrator Staff Member

  3. Bug

    Bug Well-Known Member

    Jaimee, your standard tests, patella reflex and plantar reflex should be enough but you need to ensure you know what you are looking for. How much hyper-reflexia is too much etc. Clonus or catch are also important tests to check at both the gastroc/soleus and hamstring.

    Some of the warning signs that a toe walking child should see a neurologist (and I'm of the opinion that most should unless the clinician is very experienced) include, but are not limited to the following:
    1. Prematurity
    2. Low birth weight
    3. New gait habit
    4. Unable to get heels flat on the floor without changing posture
    5. Family history of muscular dystrophy, CMT
    6. 2 or more delayed milestones
    7. Abnormal reflexes
    8. Clonus/catch
    9. Complication at birth that required a NICU or SCN stay
    10. Positive gowers sign
    11. Positive thomas test on either side + tight hamstrings
    12. Ritualistic behaviours outside the norm for their age group.

    Hope that helps?
     
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