Neuro

Question 1

boy with recent history of URI that has resolved now has ataxia, vomiting, upgoing babinski,

Answer 1

ADEM=acute demyelinating encephalomyelitis

• autoimmune demyelinating disorder in kids <10 yrs old
• follows viral or bacterial infections, immunizations
• mri: white matter plaques=demyelination
• RX: IV corticosteroids

Question 2

4 year old girl with a tuft of hair growing on her lower back has a normal exam

Answer 2

Malformed spinal cord–>tethering of the spinal cord at the base, can’t move with growth
-Lesions, hairy patches, dimples, or fatty tumours on the lower back
-Foot and spinal deformities
-Weakness in the legs (loss of muscle strength and tone)
Change in or abnormal gait including awkwardness while running or wearing the tips or side of one shoe
-Scoliosis (abnormal curvature of the spine to the left or right)
-Urinary irregularities (incontinence or retention)