When to see a child neurologist: 12 signs

1. A delayed developmental milestone: not holding the head up at 4 months, not sitting at 9 months, not walking or saying a meaningful word at 18 months, not combining two words at 24 months.
2. Loss of skills: your child has lost words they used to say, movements they could do, or social contact. This is the most important sign, and it should not wait.
3. Asymmetry: uses one hand or leg less than the other, looks to one side, or keeps one hand constantly fisted.
4. Muscle tone: a baby who is very floppy (“slips through your hands”) or very stiff; an older child who walks on tiptoes or falls often.
5. Head circumference: growing quickly or not growing; a bulging fontanelle.
6. A seizure or seizure-like episode: shaking of the body, rolling eyes, loss of awareness, bluish lips, even if it happened only once.
7. Staring spells: your child “freezes” for 5–15 seconds several times a day, does not respond when called, then carries on.
8. Recurrent headache: more than 2–3 times a month, in the morning, with vomiting, or waking your child at night.
9. Stuttering that lasts longer than 6–12 months or gets worse; your child avoids speaking.
10. Tics and unusual movements: eye blinking, face or neck movements and sounds that last more than a year or get in your child’s way; shuddering episodes, breath-holding spells.
11. Attention and activity level: present both at home and at preschool or school for more than 6 months, and getting in the way of learning.
12. Fatigue and weakness: trouble with stairs, running or getting up from the floor; constant tiredness, daytime sleepiness.

Babies born prematurely (especially before 34 weeks) or weighing less than 1,500 g, babies who had a lack of oxygen at birth, who were in intensive care, or who had severe jaundice or seizures in the newborn period. In these babies, early diagnosis of conditions such as cerebral palsy is possible before 6 months, and early intervention falls in the brain’s most plastic period.

• A seizure lasting more than 5 minutes or seizures one after another; your child does not come to after the seizure
• Fever with a stiff neck, a rash, difficulty waking, or a bulging fontanelle
• Repeated vomiting, drowsiness or a change in behavior after a head injury; a sudden severe headache; sudden weakness or speech difficulty

A one- or two-month delay in a single milestone, brief twitching in sleep, a few seconds of shaking at moments of excitement, high activity at preschool age, and temporary stalls in speech at ages 2–3 are often individual variations, and a decision to “keep watching” after an exam is entirely reasonable. But the decision should come after the exam, not before it. A study showing that a third of childhood epilepsy diagnoses turned out to be wrong also makes the point that the right diagnosis is made not in haste but through a careful exam.

A guide by age: for parents. To book a visit: contact.