Balance/walking/co-ordination

Motor abnormality with obvious local cause e.g. injury, inflammation or infection
No associated symptoms or signs
No risk factors for a brain tumour
No other abnormalities detected on examination

New onset motor abnormality that may occur with a brain tumour:

Attributing an unsteady walk (ataxic gait) to an ear infection without corroborative ear findings
Not considering swallowing difficulties and recurrent aspiration as a cause of "chestiness" in children.

Assess motor skills including:
- Sitting/crawling in infants
- Walking/running in older children
- Co-ordination e.g. heel-toe walking, finger-nose testing
- Fine motor skills, e.g. handling of a small toy / cup in young children
- Handwriting in school age children and young people
- Touching tip of thumb with tip of each finger of the same hand in turn in school age children and young people
Ask specifically about associated symptoms and risk factors:
- Personal or family history of a brain tumour
- Leukaemia
- Sarcoma and early onset breast or bowel cancer prior therapeutic CNS irritation
- Neurofibromatosis types 1 and 2
- Tuberous Sclerosis
- Li Fraumeni Syndrome
- Family history of colorectal polyposis
- Gorlins Syndrome
- Other familial genetic syndromes
Neurological examination (include assessment of vision (including acuity), gait and coordination)
Plot growth in all children and pubertal status if applicable
Plot head circumference in children under two