Acute functional deterioration in a child with cerebral palsy

Related Experiment Video

Updated: May 15, 2026

Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy
08:26

Event-related Potentials During Target-response Tasks to Study Cognitive Processes of Upper Limb Use in Children with Unilateral Cerebral Palsy

Published on: January 11, 2016

Elizabeth Smyth1, Chandrasekaran Kaliaperumal, Jane Leonard

  • 1Department of Paediatrics, Children's University Hospital, Dublin, Republic of Ireland.

BMJ Case Reports
|December 22, 2012
PubMed

Insights

A 13-year-old girl with spastic diplegia experienced rapid decline due to a newly diagnosed diffuse intrinsic pontine glioma (DIPG). This case highlights the critical need for timely diagnosis and management of DIPG in pediatric patients.

Area of Science:

  • Pediatric Oncology
  • Pediatric Neurology
  • Neuro-oncology

Background:

  • Diffuse intrinsic pontine glioma (DIPG) is a rare and aggressive brain tumor affecting children.
  • Spastic diplegia, a form of cerebral palsy, can present with varying degrees of motor impairment.

Observation:

  • A 13-year-old female with pre-existing severe spastic diplegia (GMFCS III) presented with acute functional deterioration over one month.
  • Symptoms included worsening mobility, motor function, dysarthria, dysphagia, and behavioral changes.
  • Subtle functional decline was noted by her mother in the preceding two months.

Findings:

  • Neurological imaging confirmed a diffuse pontine lesion consistent with DIPG.
  • The patient experienced rapid clinical deterioration.
  • The poor prognosis of DIPG led to the family opting for palliative care.

Implications:

  • This case underscores the importance of recognizing acute neurological decline in children with pre-existing neurological conditions.
  • Prompt neuroimaging is crucial for diagnosing aggressive pediatric brain tumors like DIPG.
  • Early palliative care discussions are essential given the grim prognosis of DIPG.

More Related Videos

A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy10:02

A Battery of Motor Tests in a Neonatal Mouse Model of Cerebral Palsy

Published on: November 3, 2016

Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy07:20

Repeated Transcranial Magnetic Stimulation Combined with Action Observation Training in Children with Spastic Cerebral Palsy

Published on: August 9, 2024

Related Concept Videos

Acute Respiratory Failure-III01:30

Acute Respiratory Failure-III

Hypercapnic respiratory failure, also known as Type 2 or ventilatory respiratory failure, is a severe condition characterized by the body's inability to effectively remove carbon dioxide (CO2) from the bloodstream. It leads to an arterial CO2 pressure (PaCO2) exceeding 45 mmHg and a blood pH above 7.35. This situation indicates that the body's ventilatory demand, or the ventilation needed to maintain normal PaCO2 levels, surpasses its supply or the maximum gas flow achievable without causing...
Secondary Spinal Cord Injury llI: Pathophysiology01:25

Secondary Spinal Cord Injury llI: Pathophysiology

Early Ischemia and Ionic ImbalanceWithin minutes of spinal cord injury, a secondary cascade begins, progressing over hours to weeks. Vascular damage reduces blood flow, causing ischemia and mitochondrial dysfunction. ATP depletion leads to ion pump failure, membrane depolarization, sodium influx, potassium efflux, and water accumulation, resulting in cellular swelling. Increased intracellular calcium further disrupts mitochondria and accelerates cellular injury.Excitotoxicity and Neuronal...
Acute Respiratory Failure-IV01:23

Acute Respiratory Failure-IV

Respiratory failure can manifest suddenly or gradually, characterized by a rapid decline in PaO2 and a rapid rise in PaCO2. This situation indicates a severe respiratory problem that may quickly become a life-threatening emergency. One of the early signs of hypoxemic Acute Respiratory Failure (ARF) is a change in mental status due to the brain's sensitivity to oxygen levels and changes in acid-base balance. Symptoms such as restlessness, confusion, and agitation suggest inadequate oxygen...
Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...
Alterations in Muscle Tone ll01:12

Alterations in Muscle Tone ll

Alterations in muscle tone are common manifestations of neurological disorders and reflect dysfunction within different nervous system regions. Spasticity, paratonia, and dystonia represent distinct forms of hypertonia, each with unique mechanisms, clinical features, and diagnostic importance.CharacteristicsSpasticity happens from upper motor neuron lesions and is characterized by velocity-dependent resistance to passive movement. Clinical features include:Exaggerated deep tendon reflexesClonus...
Acute Respiratory Failure-I01:21

Acute Respiratory Failure-I

Acute respiratory failure is a condition characterized by the inability of the lungs to perform their primary function: gas exchange. This failure leads to insufficient oxygen levels (hypoxemia) in the blood, elevated carbon dioxide levels (hypercapnia), or both, causing critical impairment in organ function.
Definition: It is defined by specific criteria based on blood gas measurements. Hypoxemia happens when the partial pressure of oxygen (PaO2) falls below 60 mmHg. At the same time,...