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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

 

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?