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A diagnostic challenge in an unresponsive refugee child improving with neurosurgery-a case report
George Makris1, Nefeli Papageorgiou2, Dimitrios Panagopoulos3
1Medical Department, Médecins Sans Frontières-Operational Centre Brussels, Athens, Greece.
Insights
Diagnosing unresponsiveness in children requires a thorough approach. A refugee child
Area of Science:
- Pediatric Neurology
- Psychiatry
- Refugee Health
Background:
- Unresponsive pediatric patients pose diagnostic challenges.
- Migratory contexts often lead to attributing unresponsiveness to psychological factors.
Observation:
- A refugee child presented with a 6-month unresponsive state after trauma.
- Initial assessments considered psychological causes like resignation syndrome.
Findings:
- Medical workup revealed tethered cord syndrome requiring surgical intervention.
- Post-surgery, the patient's responsiveness significantly improved.
Implications:
- Highlights the need for a biopsychosocial model in diagnosing pediatric unresponsiveness.
- Emphasizes thorough clinical examination and multidisciplinary approaches for effective rehabilitation.
Abstract:
An unresponsive paediatric patient may present a diagnostic challenge for health professionals, as rapid identification of the cause is needed to provide proper interventions. The following report details a challenging diagnosis of unresponsiveness in a refugee child. In the migratory context, observed unresponsiveness states are frequently attributed to psychologic factors, and overlapping psychiatric classifications (resignation syndrome, functional coma and catatonia) are common. Our patient fell into an unresponsive state for 6 months after witnessing a traumatic event. Diagnostic workup for multiple medical comorbidities led to surgical intervention for tethered cord syndrome. Shortly after that, the patient's responsiveness improved, putting to question her condition's underlying cause. This case highlights the need for a biopsychosocial approach in such cases, reflected in thorough clinical examination and diagnostic investigations. A multidisciplinary perspective and expertise proved crucial and may help in the rehabilitation of children in similar situations.
