Transient diplegia in children who fail to thrive

We describe a group of eight children seen over a 4-year period. After a few months of apparently normal health and development, the children developed feeding difficulty, failed to thrive and had mild diplegia. No other underlying pathology was demonstrated. After a period of careful attention to feeding in the stimulating environment of a child development centre, the feeding difficulty, developmental delay and diplegia all disappeared, but, by school age, the children showed learning or behavioural difficulty. It is suggested that these children suffered a subtle neurological insult during the intra-uterine period and that this predisposed them to the neurological difficulty and failure to thrive. It is important to distinguish this small group of children from those in whom non-organic failure to thrive is found and parental neglect is suspected.