CNS Examination Kit for Pediatric Assessment

Essential Components

Reflex Hammer Types:
- Queen Square Hammer
  Optimal for eliciting deep tendon reflexes in older children
- Babinski Hammer
  Features brush end for plantar response testing
- Taylor Hammer
  Ideal for newborns and infants
Sensory Testing Tools:
- Pain perception: Neurotips (disposable)
- Light touch: Cotton wool
- Temperature: Warm/cold tubes
- Vibration: 128 Hz tuning fork
Additional Tools:
- Pen torch
- Ophthalmoscope
- Measuring tape
- Head circumference chart

I: Olfactory - Not routinely tested in children
II: Optic
- Visual acuity using age-appropriate charts
- Visual fields by confrontation
- Fundoscopy
III, IV, VI: Ocular movements
- Pupillary reflexes
- Eye movements
- Nystagmus assessment
V: Trigeminal
- Corneal reflex
- Facial sensation
- Jaw movements

Tone Assessment:
- Head control
- Truncal tone
- Limb tone - spasticity/hypotonia
Power Assessment:
- Age-appropriate gross motor skills
- Fine motor skills
- Modified MRC grading for older children

Primitive Reflexes (0-6 months):
- Moro reflex
- Rooting reflex
- Grasp reflex
- Stepping reflex
Deep Tendon Reflexes:
- Biceps (C5, C6)
- Triceps (C7)
- Knee (L3, L4)
- Ankle (S1)

Age-appropriate tests:
- Finger-nose test (>5 years)
- Heel-shin test (>5 years)
- Tandem walking (>3 years)

Age-specific modifications:
- Neonates: Focus on primitive reflexes
- Infants: Developmental milestone assessment
- Toddlers: Basic coordination and balance
- School-age: Complete neurological examination
Documentation requirements:
- Head circumference (age-specific)
- Developmental milestones
- Reflex grading
- Tone assessment