Hesperian Health Guides
Examining The Nervous System
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Sometimes physical disability results from problems in the muscles, bones, or joints themselves. But often it comes from a problem in, or damage to, the nervous system.
Depending on what part of the nervous system is affected, the disability will have different patterns.
For example, polio affects only certain action nerves at points in the spinal cord (or brain stem). It therefore affects movement. It never affects sensory nerves, so sight, hearing, and feeling stay normal. (See Chapter 7.)
A spinal-cord injury, however, can damage or cut both the sensory and action nerves, so that both movement and feeling are lost. (See Chapter 23.)
Unlike polio and spinal-cord injury, which come from damage to nerves in the spine, cerebral palsy comes from damage to the brain itself. Because any part or parts of the brain may be damaged, any or all parts of the body may be affected: movement, sense of balance, seeing, hearing, speech, and mental ability. (See Chapter 9.)
Therefore, how completely you examine the workings of the nervous system will depend partly on what disability the child appears to have. If it is fairly clear the disability comes from polio, little examination of the nervous system is needed. But sometimes polio and cerebral palsy can be confused. If you have any suspicion that the disability might be caused by brain damage, you will want to do a fairly complete exam of nervous system function. Damage to the brain or nervous system can cause problems in any of these areas:
- seeing (See Chapter 30.)
- eye movement or position (See Early Stimulation and Development Activities.)
- seizures (epilepsy) (See Chapter 29.)
- balance, coordination, and sense of position.
- hearing (See Chapter 31.)
- use of mouth and tongue, and speech.
- mental ability; level of development.
- feeling (pain and touch).
- unusual or strange behaviors; signs of self-damage (See Strange Behavior.)
- muscle tone (patterns of unusual floppiness, tightness, spasms, or movements). (See Chapter 9.)
- reflexes; muscle jerks.
- urine and bowel control (See Chapter 25.)
Methods for testing some of these things are included on the next few pages and on the RECORD SHEETS 2, 3, and 4. Other tests that you will need less often, we include with specific disabilities. Refer to the links listed above.