Posted By Julia on July 06, 1999 at 09:06:01
My 12-year-old daughter has cerebral
palsyBell's palsy
Cerebral palsy
Cerebral palsy - resources
Parkinson’s disease. She has had additional problems the last 20 months which have puzzled her doctors. These symptoms include, at various times and in various combinations:
CryingColic and crying
Crying in infancy spells--sometimes pitiful, sometimes agitated, often sounding confused; nausea; vomiting; pallor; flushing of
faceFace pain and/or legs; purple
handsHand or foot spasms
Hand tremor after eating; glassy eyes; purple around eyes;
dilatedDilated cardiomyopathy pupils, sometimes responding slowly to light; fatigue; quietness (normally very talkative); low-grade
feverAllergic rhinitis
Coccidioidomycosis
Febrile seizures
Fever
Fever blister
Fever blisters and canker sores
Herpes labialis (oral herpes simplex)
Histoplasmosis
Malaria
Rheumatic fever
Scarlet fever; slightly lower temperature; reduced muscle tone; sudden and profound drowsiness.
Seizures have been ruled out by 24-hour EEG (multiple day), but during hospitalization tachycardia with some sudden brief drops in heart rate (recorded by Holter monitor) and periods of low blood pressure were noted. A few checks of blood glucose ranged from 60's to 140's. However, her symptoms and the findings do not line up consistently. She is currently taking Robinul, Klonopin, and Baclofen for her cerebral palsy (EEG was done both with and without Klonopin).
Her local doctor thought she had acute confusional migraines (without headaches), but the neurologist who hospitalized her suspects the autonomic nervous system. Would you have any thoughts on her symptoms and any ideas on doctors/centers specializing in dysautonomia testing and treatment, specifically in children? I would also like to know if the crying spells would fit with dysautonomia. The crying spells started abruptly in a very even-tempered child exactly two weeks before the onset of the other symptoms. Any thoughts on standard treament choices in children would be great, too.
Thank you kindly.
A few other options should be considered in addition to the diagnosis of cerebral palsy. One possibility is that she may have a metabolic disorder, such as a mitochondrial encephalopathy , these genertic disordes can manifest with both cardiac abnormailities, abnormalities of muscle tone and neurological problems. This group of inherited diesasew has only been recognized relatively recently and frequently tie together puzzling constellations of symptoms as you describe.
I would suggest that you seek an evaluation in a large university pedicatic neurology clinic , where you will be most likely to find some one with this sort of expertise. Yopu do not mention what part of the country you live in, the number of these specialists is relatively rare so you may need to travel. Our own expert in this area is Dr Bruce Cohen, ( 216 ) 444 5559 who deals with many of these cases, if you are prepared to travel to the Cleveland area.
Follow Ups:
Dysautonomia in a child? Julia 7/07/1999
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Re: Dysautonomia in a child? CCF Neuro[P] MD, RPS 7/07/1999
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Re: Dysautonomia in a child? CCF Neuro[P] MD, RPS 7/08/1999
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Dysautonomia in a child? Julia 7/09/1999
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Dysautonomia in a child? Julia 7/11/1999
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