title: A 10-Month-Old With Intermittent Hypotonia and Paralysis.
abstract: A 10-month-old boy presented with a 1-day history of flaccid quadriplegia and dysconjugate gaze. His history was remarkable for stereotyped episodes of flaccid quadriplegia or hemiplegia, oculomotor abnormalities, and limb or neck posturing, beginning in the first days of life and becoming more frequent and more prolonged over time. The patient was healthy and developmentally normal between episodes. Results of extensive laboratory evaluations, including EEG and brain imaging studies, were negative. The patient's history, diagnostic evaluation, and final diagnosis are reviewed. This case illustrates the importance of a fundamental understanding of neurologic localization in pediatric care and a focused diagnostic approach to an infant with paroxysmal neurologic signs.
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, beate.beinvogl@childrens.harvard.edu.
authors.forename: Beate C
authors.initials: BC
authors.lastname: Beinvogl
authors.affiliation: Division of Pediatric Neurology, Department of Pediatrics and Neurology, Boston Medical Center, Boston, Massachusetts; and.
authors.forename: N Paul
authors.initials: NP
authors.lastname: Rosman
authors.affiliation: Department of Neurology, and.
authors.forename: Fiona M
authors.initials: FM
authors.lastname: Baumer
authors.affiliation: Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Lance H
authors.initials: LH
authors.lastname: Rodan
authors.affiliation: Division of General Pediatrics, Department of Pediatrics.
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Forster
authors.affiliation: Division of General Pediatrics, Department of Pediatrics, Department of Anesthesiology, Perioperative and Pain Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Albert H
authors.initials: AH
authors.lastname: Kwon
authors.affiliation: Division of Genetics and Genomics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts;
authors.forename: Gerard T
authors.initials: GT
authors.lastname: Berry
mesh_terms: D003937:Diagnosis, Differential; D006429:Hemiplegia / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007223:Infant; D008297:Male; D009123:Muscle Hypotonia / Q000209:etiology*; D011782:Quadriplegia / Q000209:etiology*