Year: 1998
Type: article
Study design: Case Report
Abstract: HISTORY OF PRESENT ILLNESS The patient was the full-term product of a normal pregnancy and delivery. She had good growth and development in the first year of life, but her mother always thought that her muscle tone was decreased. She sat unsupported at 6 months, crawled at 8 months, and pulled to stand at 10 months. She didn’t walk alone until 17 months of age, never quite achieving normal gait and falling several times a day. At age 2 years she underwent an extensive neurologic evaluation, including brain CT and MRI scans, myelogram, as well as blood and urine tests to screen for known metabolic disorders. No structural or metabolic explanation for abnormal gait was found, and she was given a diagnosis of choreoathetoid cerebral palsy. She continued to make slow progress with motor milestones, walking up steps at 3.5 years and riding a tricycle at 7 years. Cognitive development was within normal limits but she had difficulty with fine motor skills. She babbled at 6 months, spoke 1 word at 12 months, and 3-word sentences by 3 years. Over the past 2 years, the parents have noted slurred speech and drooling. She always had difficulty putting puzzles together and her drawings were awkward. Psychologic testing, performed at 6.5 years documented a WISC verbal score of 123, a performance score of 86 and full scale score of 105. She is presently in a regular second grade class in school. Review of systems was generally unremarkable. The patient had a history of chronic/recurrent otitis media from 1 to 3 years of age, that resolved. She had been treated 4 times for sinusitis over the past 12 months. Multiple warts had been present on the hands for 6 months. She never had been hospitalized, and was taking no medications. She had received all age-appropriate childhood immunizations. There was no family history of cerebral palsy or other neurologic disorders, chronic infections, or immunodeficiency. Her parents were of German and Swiss origin, and were not consanguineous. The patient had 2 healthy siblings, a 15-year-old sister and an 11-year-old brother.
Authors: Anna H Nowak-Wegrzyn, Howard M Lederman
Institutions: Johns Hopkins University, Johns Hopkins Medicine
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $3,400
Award: G373348672
OpenAlex ID: W1982161694