Neurological “soft signs” in children and adolescents

Neurological “soft signs” (NSS) are defined as minor abnormalities in the neurological examination in subjects with no other features of fixed or transient neurologic disorders [1]. These clinical disabilities are often associated with behavior, coordination and learning difficulties. The prevalence of motor examination abnormalities among a normal pediatric population is unknown; about this aspect, studies performed have given different results in children examined at seven and seventeen years [2]. In this issue of JPN, Wu et al. [3] investigated the frequency of motor abnormalities in a random sample of healthy 5-year-old children, and then they examined the relationship between these motor abnormalities and standardized measures of cognition and motor performance. Based on their findings they have concluded that motor examination abnormalities in otherwise healthy 5-year-old children may be more common than previously thought. However, the proportion of children with motor examination abnormalities who have an unrecognized neurologic disorder remains unknown [3]. The main factors that may determine the appearance of NSS are: