General: Head circumference (percentile for age)
Dysmorphic features (including palate, ears, hypertelorism in neonates)
Anterior fontanelle
Head shape: flattening of occiput, craniosynostosis
Exam of spine, cardiac abnormalities, hepatosplenomegaly, cutaneous lesions e.g. ash leaf spot:

cafe au lait spots

Mental Status: Orientation: e.g. to place/time
Attention and Concentration: alert, lethargic, comatose; distractible, following commands well;
in neonate: regarding faces, tracking, staying awake; in infants: assess milestones (tracking across midline, grasping objects, etc.)
Language: appropriate for age, aphasic
Fund of Knowledge: able to do simple math or read
Memory: knows address, 3/3 items at 5 minutes
In comatose patient, when was their last sedation? Are they paralyzed? Do they respond to name with eye-opening? With vital sign changes?
Glasgow Coma Scale

Cranial Nerves: II: red reflexes in neonates, fundoscopic exam, visual fields: visual fields full to confrontation, visual acuity: 20/20, blink reflex elicited, pupils reactive
III, IV, VI: conjugate movements, no strabismus, EOMI (by tracking toy or by vestibuloocular/dolls eyes reflex), ptosis, nystagmus
V: sensation intact to light touch, corneal reflex present bilaterally, can also assess with jaw-jerk reflex, palpation of jaw muscles
VII: Assess symmetry when relaxing and when smiling, raising eyebrows, closing eyes, focus on nasolabial folds, look for facial droop: if unilateral upper and lower face consider LMN lesion (Bell's palsy), if lower unilateral face consider UMN lesion (e.g. stroke). Efferent pathway of corneal reflex assesses CN VII, in neonates strength of suck
VIII: hearing intact to whisper, assess for nystagmus
IX/X: palate elevates symmetrically, look for uvula deviation, gag intact, can comment on quality of voice/cry if abnormal
XI: sternocleidomastoid and trapezius symmetric strength
XII: tongue midline
In comatose patient, initiating their own breaths?

Motor: Bulk: normal (observe with clothes off), atrophy
Tone: traction response normal, positive head lag, slip-through on vertical suspension
Should lift head and rump on horizontal suspension, fisting of hand, assess changes of tone with rapid passive movement, determine if tone is more abnormal centrally or peripherally
Strength: 0/5 to 5/5 (1/5 flicker, 3/5 to gravity, 5/5 full resistance), in neonates moving all extremities equally
pronator drift
Motor development? (chin up when prone, sits without support)
Gait: bears weight bilaterally, normal toe, heel, tandem walking, wide-based, watch for adventitial movements

Coordination: no dysmetria on reaching for toys/on finger-nose-finger or heel to shin testing, rapid alternating movements: finger-tapping rhythmic
titubation (truncal ataxia)

Reflexes: 0 (not elicited) to 4 (clonus) with or without crossed adductor
Moro: symmetric (to 3-5 mos)
Tonic neck: normal, asymmetric or sustained (never fixed; to 6 months)
Propping: present (6 to 7 mos; for sitting without support)
Parachute: present (9 mos; for walking/falling)
Grasp of palms/soles: (3 months)
Stepping reflex (1-2 months)
Babinski present/absent, Hoffman's sign

Sensory: Cries with, localizes, purposefully withdrawals to painful stimuli in all 4 extremities, to all modalities (light touch, vibration, position sense, pain, temperature) romberg sign

Adapted from Dr. Amy Kao's exam handout
See also: U Utah: Pediatric neuro exam