MANAGEMENT STRATEGIES IN A CASE OF POTT`S SPINE WITH DOWN SYNDROME- A RARE ENTITY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 8
Abstract
PRESENTATION OF CASE A 14 yrs. old male child, a known case of Down syndrome was referred to our center with chief complaints of gradual onset pain in mid-back region and inability to walk for the past 5 months. He also had impaired bladder and bowel control, evening rise of temperature and significant weight loss during this period. Patient was already on anti-tubercular chemotherapy for the past 2 months and was advised complete bed rest however; there was no improvement in general and clinical status as per history. There was also past history of microbiologically proven pulmonary tuberculosis 2 years back for which he took ATT for 6 months. On clinical examination, stigmata of down syndrome were noted (Moderate intellectual disability, umbilical hernia, stunted growth, short neck, anorectal malformation etc.). On local examination, angular type of kyphotic deformity was noted over T9-T10 region with para-spinal muscle spasm as well as direct and rotatory tenderness. On neurological examination, due to intellectual disability, accurate interpretation was not possible, however, there was decreased muscle bulk, positive Babinski sign, clasp knife spasticity in both the lower limbs along with exaggerated DTRs. Paraparesis was noted in both the lower limbs (Frankel Grade C) along with loss of bowel and bladder control without any involuntary movements. Sensory examination and spinal level could not be assessed accurately due to lack of patient co-operation. Nevertheless, loss of sensations below the level of umbilicus was apparent clinically
Authors and Affiliations
Jujhar Singh, Sarvdeep Singh Dhatt, Vishal Kumar
Keywords
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- EP ID EP554999
- DOI 10.14260/jemds/2019/119
- Views 80
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