Neuromuscular Disorder - pediatric oncall

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Neuromuscular Disorder

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Rakesh Kumar, Puja Bhagat Department of Pediatrics, Katihar Medical College, Katihar, Bihar, India ...

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	Specialist Answers
Question Category : Neuromuscular Disorder
A one yr old female child presented with "loose body" no other complaints milestones ok only complaint was bowing of legs and difficulty in standing straight and holding tight diagnosis ; benign congenital hypotonia syndrome what advise , precautions , exercises , and education to mother would be right what do we expect mentally in the child is she to be treated as a normal child ? Check Out the Answer
Question Category : Neuromuscular Disorder
An Obs.colleague asks for help;very sketchy history;outstation couple;2issues;alright till 4th.month; both developed ascending paralysis beginning legs;expired around 12 mts.planning 3rd;suggestions please;I am stumped. Check Out the Answer
Question Category : Neuromuscular Disorder
13 yr male presenting with wrist drop of sudden onset. duration of illness 25 days. no h/o trauma, fever.sensory system normal x-rays cervical spine normal. NCV- Lt radial nerve cond velocity decreased. what is the cause of this isolated non painful motor neuropathy? Check Out the Answer
Question Category : Neuromuscular Disorder
My biggest problem is that my institute receives meningoencephalitis cases from all over Delhi and adjoining areas in such bad shape that we hardly have time to send cultures and work out a strategy. Most already having received the common third gen cephalosporins at private places for few days. Resultant we loose them without even giving a fight. My question is are we really helpless when it comes to encephalitis ( mortality rate being 60-70% in my experience) 2) please can you give me an approach regarding investigating and reaching a diagnosis, which is both speedy and cost effective in helping save such kids? 3) On what grounds can acyclovir be started? 4) Please also share the most effective strategy treatment wise keeping in mind the short window period that most of the times we have? Please help me at the earliest. Thank you ! Check Out the Answer
Question Category : Neuromuscular Disorder
What is meant by A]double hemiplegia B]CROSSED hemiplegia C]Pseudobulbar palsy Check Out the Answer
Question Category : Neuromuscular Disorder
Sir, my son known case of menigomylocel, six years old, operated at hinduja hospital on the second day of birth, the second operation at Jaslok tetheared chord relased , physiotherapy continued since birth till today, facing two main problems 1. left leg sensession are nil and shortning by 1.5 inches, urine and stool , brain all are normal. Now i request for the information about 1. what is your advise for left leg sensession? 2. what to do for shortining of left leg? 3. what are the chances of occurrence of same diseases in next child? I am not a doctor , but to register I had done this thing. It's on your wish to reply these questions . i being a father request you please please please please please please please please pl,,,,,,,,,,,ease. sonu. thank you. Check Out the Answer
Question Category : Neuromuscular Disorder
How long can one wait for brachial plexus injury to recover caused due to birth injury?Are surgical corrections being done in India and if so which are the centers? Check Out the Answer
Question Category : Neuromuscular Disorder
Dear sir I am iraqi pediatrician.My son 2y old delivered vajinaly with cephalhematoma.On the 2nd day apenc spells started for many times,admitted in hospital for O2,steroid ,AB,luminal.Discharged after 5days with no more fits.Now he is 2y hypotonic with exaggurated reflexes,right-sided hemiparesis.He can sit un assisted but cannot pull himself to sit while he is lying.He can stand for few seconds freely.He can move from one place to another by creeping or rolling.Till now when he catches any thing brings it to mouth probably because his right arm is weak.He can say few words.He is very concerned about himself,he can remember painful events.He has good vision &know us but never look face to face just rapid glance is enough to see other.What is your opinion about my son ,prognosis&what he needs to help him thank you....? Check Out the Answer
Question Category : Neuromuscular Disorder
1. Treatment of excessive salivation of a 9 months old child though oral cavity is clinically normal 2. Treatment of excessive sweating of a 2 yrs above child Check Out the Answer
Question Category : Neuromuscular Disorder
what is osas ;obstructive sleep apnea syndrome? Check Out the Answer
Question Category : Neuromuscular Disorder
Wanding hoffman syndrome Check Out the Answer
Question Category : Neuromuscular Disorder
What is a soft spot on the head of a young child and what is it's significance?does a hit on this part make some difference? Check Out the Answer
Question Category : Neuromuscular Disorder
How patients with GBS should be monitored in ICU for respiratory involvement. what are standard clinical and lab tests. at which stage ventilatory support should be started Check Out the Answer
Question Category : Neuromuscular Disorder
My What should be the fluid of choice for patients with Intracranial hypertension.Current recommendations for managing raised ICP Check Out the Answer
Question Category : Neuromuscular Disorder
2 yr mch boncm has rt lateral rectus palsy following a episode of fever and conjunctivitis since one yr. he has normal perinatal history with normal development of milestones. on neurological examination pupils normally reacting and lat rectus palsy. rest of the examination is normal. what r possible differential diagnosis Check Out the Answer
Question Category : Neuromuscular Disorder
I want to ask about one patient.4 yrs old female child.c/o lipomeningocele.operated at 6 mhs of age by pead surgeon.operated by neurosurgeon at 2 yrs of age.she has weakness below waist.gr 4 minus power below waist.leg and foot deformities.can walk with support.mentally normal.has urinary and bowel incontinence.now mother c/o some sensory loss both feet.she has been tried by mother all therapies .phisiotherapy,acupuncture,laser,ayurvedic,etc. now she is in normal school.but problem is her urinary bowel incontinence.parents thinking that mentally she is normal so put in normal school. i want ask following queries 1.how to rehabilitate her 2.use of calipers 3.if having sensory loss what about walking,calipers etc. 4.is there any special school for her.she is from pune(chinchwad) 5.is any other option of treatment along with present like homeopathy etc. 6.any training centre for special treatment Check Out the Answer
Question Category : Neuromuscular Disorder
Is it possible that in LMN lesions say NM Junction lesions or myopathies, Deep tendon reflexes be brisk? Why i ask is recently we had a 6yr old child presenting with weakness, generalised wasting, hypotonia, exaggerated lordosis, waddling gait all fitting into myopathy. But her deep tendon reflexes were brisk except that knee jerk was absent. pl give ur comment. Check Out the Answer
Question Category : Neuromuscular Disorder
I have a pt. 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? Check Out the Answer
Question Category : Neuromuscular Disorder
Can you give me the most accepted and result wise best regimen for steroid resistant and steroid dependent nephrotic syndromes?... 2). how many times does a CSF culture return positive for fungal meningitis? Can't antifungal be started empirically if patient fails to respond to usual antibiotics and the sensorium continues to deteriorate?... 3) Is it contra-indicated to use steroids and mannitol if NCCT skull shows cerebral parenchymal bleed and a child has features of raised intra cranial tension? what possible remedies for it if not the above two? Thanks for the help PEDIATRICIAN ON CALL !! Check Out the Answer

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