Specialized Neurological Studies

A variety of specialized studies are available for evaluating the nervous system of the newborn. In this chapter, we review several commonly used tests: cerebrospinal fluid examination, evoked responses (with emphasis on auditory evoked responses), electroencephalography (EEG), cranial ultrasound, and magnetic resonance imaging (MRI). We also touch on some tests that are not yet in common clinical use: near-infrared spectroscopy and magnetoencephalography. The discussion of EEG includes a description of the changes in EEG associated with early brain development and a brief review of amplitude-integrated EEG. The discussion of MRI covers conventional structural imaging (including diffusion imaging) as well as spectroscopy and functional imaging. Overall, we focus on the adaptations necessary to optimize these tests for infants. We also describe the characteristics and nuances relevant to their effective clinical use. The application of most of these tests for diagnostic purposes is mentioned in various other chapters of this book.