Acute_Flaccid_Paraplegia

Acute_Flaccid_Paraplegia - Approach to a child with...

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Unformatted text preview: Approach to a child with weakness Dr. Pushpa Raj Sharma Professor of Child Health Institute of Medicine Weakness/paresis/paralysis Upper Motor Neuron. Upper Motor Neuron. Lower Motor Neuron Lower Motor Neuron Myopathic Myopathic Pattern of weakness Sign UMN LMN Myopathic Atrophy- +++ + Fasciculations- +++- Tone +++- +/- Distribution Regional Segmental Proximal Tendon reflexes +++-/-- +/- Babinskis sign +-- Important fact: When there is a discrepancy between the history and physical findings, it is usually because the patient complains of weakness , whereas symptoms are actually due to other causes. Child Abuse may be the cause. Motor Neuron Disease Asymmetric Upper and lower motor neurones Amyotrophic Lateral Sclerosis (ALS) Sporadic ALS Hereditary ALS Superoxide Dismutase ; Chromosome 21; Dominant Other ALS: Recessive & Dominant Multi-system disorders ALS with Ophthalmoplegia & Extrapyramidal Disorders Polyglucosan body disease Motor neuronopathy with cataracts and skeletal abnormalities Multiple system atrophy Symmetrical and proximal SMN : Chromosome 5q; Recessive Androgen Receptor (Bulbo-spinal Muscular Atrophy) : X-linked; Recessive Hexosaminidase A (Tay-Sachs) : Chromosome 15; Recessive Hand weakness Bulbar involvement Motor Neuron Disease Lower motor neurones only Distal Lower Motor Neuron (LMN) Syndrome IgM vs GM1 ganglioside IgM vs GalNAc-GD1a ganglioside Also see: Multifocal motor neuropathy Proximal Lower Motor Neuron Syndromes Brachial amyotrophic diplegia ? Associated with IgM vs asialo-GM1 Rare: Upper > Lower limbs with anti-Hu antibodies Motor Neuron Disease...
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This note was uploaded on 12/24/2011 for the course STEP 1 taught by Professor Dr.aslam during the Fall '11 term at Montgomery College.

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Acute_Flaccid_Paraplegia - Approach to a child with...

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