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By Ingrid Gamstorp (Auth.)

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The steadiness of leg movements can be evaluated by asking the child to tap seven times with o n e heel on a given point on the other shin. 34. Patient and examiner competing in rapid small movements of thumb against forefinger Diadochokinesis can best be tested by asking the child to tap the palm of one hand with the other hand, alternating as fast as he can between the back and the palm; the tapping hand is the one being tested. 35). Examiner and child must always match their best hands against each other.

Consistent reponses from both eyes when the test is performed from one side, but never when performed from the other side, will be seen in an infant with a visual field defect or a parietal lobe lesion. Examination of the head Measurement of head circumference will give a crude estimate of the growth of the brain. T h e growth of the head is due to pressure from inside the skull, normally caused by the growth of the brain. A mean for the head circumference in the newborn period is 3 4 - 3 6 c m , at 6 months 4 3 - 4 5 c m , at 1 year 4 8 - 5 0 c m , and at 5 years 5 0 - 5 2 cm.

24. 1). 25. 26. 27. 28. A 10-year-old boy with a right-sided hemiparesis demonstrating a positive Grasset sign. N o t e the flexion of the elbow, the pronation of the hand, and the patient's inabiHty to keep his fingers stretched and together a comparison may be difficult. T h e resistance to supination can also be seen when the child is told to stretch his arms out in front of himself with palms u p (Figure 229). 30). Muscle tone can be evaluated only when the child is relaxed; the relaxation can often be facihtated by gentle shaking of the limb.

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