Monitoring of Neurologic Function

The most important aspect of assessing neurologic function is the clinical examination. In an awake child, interactions with the examiner and caretakers are sensitive indicators of high or integrative cortical function. When the child's cognitive function is depressed from disease or drugs, examination of gross motor function, the general level of activity, and peripheral and brainstem reflexes becomes an important, albeit crude measure of CNS function. The Glasgow Coma Scale (GCS) has been used to quantitate the level of function in neurologically impaired patients ( Table 76-12 ). ^[190] A pediatric GCS has been developed to obviate problems in a child without language skills ( Table 76-13 ).