S. Piris Borregasa, M.R. Acuña Allerb
aMIR-Pediatric.
12 de Octubre University Hospital.
Madrid.
Spain. bPediatra.
CS Martin de Vargas.
Madrid.
Spain.
1.
In a review of a two-year-old girl, her bedside pediatrician discovers a clumsy gait: knows standing without help, doesn't know how to run, hit the ball with both feet and climb.
No familial neurological alterations of interest were described.
Personal History
Born after a term pregnancy by cesarean section due to presentation may occur.
Birth weight, 2780 g; Apgar test, 8/9; resuscitation type II.
Endocrine and metabolic tests were normal.
Vaccination a day.
Psychomotor development: social smile at two months, support at three months, thirst at seven months, gateo at eight months, march without 17 months, motor support normal.
Non-referential bi-syllables at eight months, reference bisyllables at 12 months.
Establishment
Talla, 92 cm (97th percentile [P97]); weight, 11.8 kg (P25-50); skull perimeter.
53.3 cm (P97).
Good general condition.
Well nourished.
No dysmorphia or dyschromia.
Normal skull shaped.
Cardiopulmonary arrest normal.
The abdomen was depressible and without organomegaly.
Female and normal external genitals.
blinking; non-reflexive goniometry; longilí habit with good alignment of the raquis and extremities; normal cranial nerves; normal active tone; mild passive hypotonia with signs of overbite
Subsequent payment
The patient is admitted to the Neurology Department with clinical control every three months.
Blood count, general biochemistry, thyroid tests and creatine phosphokinase were requested, with normal results.
During the following six months the child developed a macrocephalia of +3.6 standard deviations (SD) and a slight intentional tremor, without improvement of the motor clumsiness in the ambulation Dandy complex brain magnetic resonance imaging was requested.
Neurology recommended physiotherapy using the Bobath method, with which neurological deterioration has stopped at the moment.
1.
Corresponding address: Salvador Piris Borregas dockbps@hotmail.com
