THE SEMINAR was conducted in four 3-hour sessions and aimed to cover the more important features of pediatric neurology.
Dr. Hawke reviewed the normal development of the central nervous system in the infant and child which is so important in the assessment of neurologic disorders in this age group. It was noted that the nervous system was particularly immature and changing rapidly in the first 2 years of life. Development was related to myelination and it was emphasized that this was not a steady process but a pattern of sequences of rapid and slow growth. Motor and sensory development appeared to develop from above and to proceed downward, so that eye-control develops before hand- and legcontrol. Development was related to three functioning levels of the central nervous system—the brain stem, the archipallium, and the neopallium. It was observed that the newborn baby functioned at the brain stem level, and to illustrate this an example was given of the hydranencephalic baby which behaves perfectly normally for the first few weeks of life. The anchipallium, which includes part of the temporal lobe, the cingulate gyrus and basal ganglia, supervenes on the brain stem and may be considered responsible for the basic emotions and some primitive motor and sensory control. The neopallium, which includes most of the cerebral hemisphere, becomes dominant in primates. Its function is intellectual rather than emotional and is responsible for skills, discrimination and fine movements. The clinical application of these developmental patterns are innumerable but illustrations were given of changes in physical signs in static brain lesions.
- Copyright © 1957 by the American Academy of Pediatrics