PAEDIATRIC NEUROLOGY

c Neurology is something of a novelty and a rarity, a specialism within a specialism. Therein lies a peculiar danger, for there is a risk of a limitation of clinical experience within a narrow age-span, a process which is tantamount to exclusivism. Longitudinal studies of patients with chronic maladies are apt to be artificially truncated by the intervention of a ban imposed by too early an age-limit. This is an important drawback, and we recall immediately the frequent differences between epilepsy in the first years of life and its picture in adulthood. All too often the fascinating pursuit of comparing and contrasting the experience of morbid patterns as they show themselves at different ages is apt to be denied. The rich field of geriatrics lies far beyond the wall and is unattainable. Again this is unfortunate because some aspects of dissolution of the nervous system resemble those of development. Special hazards surround the neurological paediatrician. Much of his work rests at the merely descriptive stage which is reminiscent of neurology as it was at the end of the 19th century. An even greater drawback lies in the nomenclature, which at present is inacceptable, being all too often muddled, or crude, or inexact, some of it being wished upon neuro-paediatricians by their colleagues in other disciplines. The foregoing remarks appear critical, but in the other scale of the balance there must be placed many arguments which are overwhelming in their weightiness. The growing edge of neuropaediatrics embracing genetics, and the biochemical dyscrasias which increase in number yearly constitute one of the most exciting and promising vistas for Medicine of the future. Children as patients are particularly satisfying, for their physical signs are as a rule easy to elicit, and as historians they are unusually honest-though perhaps put into a wrong perspective by parental prejudices and interventions. When it comes to the newborn and very young infants, a completely new technique of neurological examination is at once called for, with fresh orientations. Neonatal or developmental neurology raises problems entirely of its own, and it would be rash to deny that the territory has as yet been merely superficially explored. Even in the case of older children it can be said that we are still not sufficiently