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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 348:735-743 February 20, 2003 Number 8
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Case 6-2003 — A Nine-Year-Old Girl with Progressive Weakness and Areflexia
Howard W. Sander, M.D., and E. Tessa Hedley-Whyte, M.D.

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Presentation of Case

A nine-year-old right-handed girl from the United Arab Emirates was admitted to the hospital because of progressive weakness and areflexia.

The patient had been well until three months earlier, when a gait difficulty developed. A physician diagnosed a vitamin deficiency, and treatment was instituted but without benefit. One month later, progressive weakness and a slapping gait developed; she was unable to walk on her toes and could barely rise from a full squat. Another physician found that she had both proximal and distal weakness in the arms and legs, that the reflexes were absent throughout, and that the sensation of . . . [Full Text of this Article]

Differential Diagnosis

Chronic Inflammatory Demyelinating Polyradiculoneuropathy

            Hereditary Causes of Demyelinating Neuropathy

            Vitamin Deficiencies

            Arsenic Poisoning

            Infections

            Other Disorders

Concurrent Illnesses

Treatment of Chronic Inflammatory Demyelinating Polyradiculoneuropathy

Clinical Diagnosis

Dr. Howard W. Sander's Diagnoses

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Peripheral Neuropathy Center and the Department of Neurology, Weill Cornell Medical College, and the Department of Neurology, New York University School of Medicine — both in New York (H.W.S.); the Department of Neurology, New York Medical College, Valhalla, N.Y. (H.W.S.); and the Department of Pathology, Massachusetts General Hospital and Harvard Medical School — both in Boston (E.T.H.-W.).


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