Seminars in pediatric neurology
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Semin Pediatr Neurol · Jun 2011
Genetics and child neurology: what every trainee/resident should know.
The training of residents in child neurology varies from one center to another, being influenced to a large extent by the nature and volume of the clinical practice at a specific center and the expertise of the faculty. There is no doubt that there is an undercurrent of genetics in everything we do as child neurologists, sometimes explicit and sometimes implicit. In this article, we highlight a fundamental set of concepts, principles, methodologies, and learning tools/resources of which every child neurology trainee should have some knowledge. We may eventually arrive at a child neurology curriculum that might be continuously revised and maintained (perhaps through the Child Neurology Society) and serve as a template for individual training programs.
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The field of pediatric neuromuscular disorders provides rich training experiences in child neurology residency programs. Specific learning objectives include skills in examination and assessment, familiarity with muscle and nerve studies, and indications for biopsies. This review also specifies which neuromuscular disorders are most important to cover within the resident's scope of knowledge, as well as the relationship of this field to the core competencies of residency training. Appropriate settings for inclusion of these skills in child neurology residency programs are suggested.
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As traumatic brain injury is among the most common causes of pediatric mortality and neurologic morbidity, the well-trained child neurologist should have a solid foundation of the pathogenesis of traumatic brain injury and be competent in the acute and chronic management of children and adolescents who experience a traumatic brain injury. This article outlines the training goals and core knowledge of traumatic brain injury that should be attained by those training in child neurology by the completion of their formal training.
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Neurocritical care (NCC) is now an essential field in child neurology that requires dedicated training. NCC applies the basic principles of neuroresuscitation to all situations, integrates this with modern technology. and emphasizes that brain protection is not limited to the intensive care unit. We outline the essential competencies needed and how to obtain these.
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Inborn errors of metabolism (IEMs) are individually rare, but collectively common, and impose a burden on affected individuals, their families and society that is disproportionate to their individual incidence and prevalence. Child neurologists should be able to recognize the possibility of an IEM as the cause of their patients' symptoms and signs, and utilize online and print resources to initiate an appropriate work up and referrals. ⋯ They should also be prepared to manage affected children as part of a multidisciplinary team that draws on the skills of other professionals and community organizations. Because of rapid advances in diagnostic technology and the improving survival of children with IEMs, all child neurologists should anticipate caring for children and families with IEMs, and must acquire the ability to diagnose and manage these disorders as part of their residency training, recognizing that maintenance of this competence requires a commitment to life-long learning.