4th Pediatric Infectious Diseases Conference
 
 
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Neuromuscular Disorder
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Specialist Answers
Question
I have a patient admitted with history of neck flop and generalized hypotonia (on examination)for past 10 days.No history of febrile illness, diarrohea, painful limbs, respiratory difficulty.Mother gives history of nasal regurgitation of fluids for past 3 days but on examination child seems to be accepting breast feeds comfortably. She does recall some posterior neck swelling which she thought was result of some trauma and which subsided on its own around same time. O/E- tone is reduced in all 4 limbs, DTR's- NE, Plantar's- flexor ! Gag reflex present, but poor movement of palate. Poor cough and hoarse cry. What does it make the case look like? I am suspecting post diptheritic palatal palsy as the child is unimmunized ! Please bail me out?
Answer
Rule out bulbar polio. Other causes such as hypokalemia and GBS should also be ruled out. Post diphtheric palsy is unlikely without a previous history of bull neck and membrane formation.
 
 
 
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