Testing for my children?

What is everyone's experience with what if any screening should be done for CM for my children? I have a 10 year old that has coordination issues as well as a few other symptoms but no headaches. I'm just wandering if they all should be screened just in case or only if they have CM symptoms. What has everyone done about their children? Do they see the primary care Dr. or the neurologist? Thanks in advance for your help.

The discussion I typically have with patients is that up to 3-5% of the population is walking around with some degree of cerebellar tonsillar ectopia. If you have a first degree relative with cerebellar tonsillar ectopia, you double that risk.

Therefore, routine screening in asymptomatic patients is not recommended. In children in particular, anesthesia is often required to obtain the MRI. In an asymptomatic patient, no treatment is recommended. So you have exposed your child to anesthesia( a low, but not 0, risk event) to gather data with which nothing will be done(other than, perhaps, if negative, some peace of mind).

I would talk to your PCP, make sure they know your family history, and see if the PCP finds anything else that would make them concerned for cerebellar dysfunction.

That being said, in patients in whom symptoms are severe enough to consider surgery(and that really the only time you get an MRI, right, when you are looking for a lesion that may explain the symptoms and be amenable to anatomic treatment(surgery)), I have a very low threshold to recommend an MRI.

Thank you for your thoughts. I appreciate your input.