Neurotransmitter and neuromodulatory systems provide the mechanism for communication between nerve cells in the central nervous system. Studies of synaptic neurotransmission within the brain during development and in pathologic conditions are furthering our knowledge of various pediatric disorders. Basic concepts of synaptic neurochemistry, evaluation strategies, and the development of neurotransmitter pathways are reviewed. Sections on movement and psychiatric disorders, hyperactivity, epilepsy, and hyperphenylalaninemia relate clinical pediatric situations to recently reported alterations of neurotransmitter substances. The emerging story of neuropeptides and their association with pain further illustrate the importance of neurotransmitter research.

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