Case of the week: 7-1-2004

Left Spastic Hemiparesis

Age: 12 years
Weight: 53 kg.
Height:157 cm

History

Born in a Bosnian hospital by vacuum extraction following prolonged labour. No intrauterine infections, neo-natal jaundice or Rh incompatibility. Currently living in Malta.

Walked at 18 months, noted to be turning his left foot outwards with equinus. Able to walk and run. Obvious dystonic posturing of left hand with dystrophia and brisk reflexes. Can reach out and pick up things with it if requested, but in the main does not use it.

Normal cognitive development, can speak both English and Croatian, finished 5th in his class. Lively and excitable and can concentrate on many things.

Epilepsy: has had seven to eight seizures, the first in August 1996, with intermittent twitching movements of the left hand.. He was quiet but not unconscious. Had several further episodes of twitching of the left hand, accompanied by gastro-enteritis. One of them occurred after a bang on the right side of the head, the latter associated with vomiting, twitching of the right eyelid and unconscious for 20 minutes, with palor and apnoea. EEG & CT scan appeared to be normal. Not on any medications. Last seizure (mild) occurred on January 10th 2002, also accompanied by vomiting.

Movies

AVI format
Sagittal
right side left side
Frontal front view rear view ascending stairs

WMV format (smaller but may not play on your PC)
Sagittal
right side left side
Frontal front view rear view ascending stairs

Points for discussion

A lengthing of the left tendo-Achilles has been tentatively scheduled:

What people said...

3D Gait Analysis Results (performed by Dr. Ernst Zwick MD, University Clinic of Children's Surgery, Graz, Austria)


Points for discussion



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