Ty-Jour T1 - 健康5岁女孩JF的急性共济失调和热情 - Pediatrics Review Jo - Pediastr。ManBetx旧版Rev. SP - 329 LP - 331 Do - 10.1542 / PIR.2020-0007 VL - 42是 - 6 AU - Taylor,Richard J. Au - Ritter,David M. Au - Frazier,Maria E. Au - Zackoff,Matthew W。Y1 - 2021/06/01 UR - http://pedsinreview.aappublications.org/content/42/6/329.abstract N2 - A 5-year-old girl presents to a southern Ohio pediatric emergency department in early August with a chief complaint of “walking like a drunk.” The family reports that she woke up with trouble walking, multiple falls, and pigeon-toed gait. She endorses intermittent vertigo that resolves with sitting and complains of her legs feeling as if they “are asleep.” The family denies recent travel, change in medications, recent illness, fever, headaches, changes in vision, changes in speech, abnormal eye movements, or altered mental status. The patient’s mother has gabapentin at home, but no pills are missing. She was born full term with no complications and normal development. Her family history is notable for peripheral neuropathy in her mother and a childhood brain tumor in her maternal uncle.On examination her vital signs are within normal limits for age and she is warm and well perfused, with normal cardiac, pulmonary, and abdominal examination findings. Her neurologic examination is significant for sustained nystagmus on lateral gaze, bilateral dysmetria on finger to nose testing, and unsteady gait with bilateral foot inversion. Her reflexes are normal except that her patellar reflexes are not able to be obtained secondary to her inability to relax. Otherwise, her cranial nerve, sensory (touch, temperature, and vibration), and motor examination findings are normal. A noncontrast head computed tomographic scan is normal, and a urine drug screen is negative. She is admitted to the neurology service for observation. She does well overnight but on waking the first day of admission the family reports an episode of urinary incontinence, inability to feed herself, new-onset global weakness with a predominance in the extremities, and difficulty swallowing. Her examination is now notable for inability to sit upright, strength 4/5 throughout, and absence of deep tendon reflexes.Further evaluation is initiated, … ER -