3 year old woke up unable to walk

[kettlerj]

I have a 3 1/2 year old who suddenly woke up one morning unable to walk.  He said his legs "hurt" and crawled almost all day until later in the evening when he attempted to walk 3-4 steps at a time on the very tops of his toes but then got down to crawl again.  After 24 hours or so...the next day mid day....he was able to walk pretty much normally again.  We did not take him in to see a doctor on the day that the symptoms occurred, but wish we had.  He was not sick or injured at the time.  His medical history includes a febrile seizure when he was 2 and at about 18 months he had a two day period where he was off balance and fell a lot.  We took him to the Dr. then who did testing and then sent him for an MRI to check for a brain tumor.  No brain tumor but there were some scattered T2 hyperintensities in the periventricular region.  The report indicated that it could be due to delayed myelination but no evidence of leukodystrophy.  We then took him on to a pediatric neurologist at that time who did an exam and found nothing remarkable.  He met all of his milestones after this time.  The neurologist said that his episode could have been a form of a migraine and did note that there were some hyperintensities on the MRI report as well, but didn't give a reason for this specifically.  We never really came to many conclusions and were told we didn't need to return unless symptoms came back.  Thankfully nothing has until this past week as I described when he woke up unable to walk.  Our Dr. recommended we take him back to see the neurologist but we can't get in for 5 months!  I am just wondering what your thoughts on this may be?  What should be checked when we do return to the neurologist?

Thank you so much!!

[kettlerj]

Thanks for your reply!  This makes me feel less worried.  He was taking medicine at the time for bronchitis and after reading more I think myositis fits. We will be sure to take him in if it happens again now that we know.  I'm glad the symptoms resolved quickly too. It's very reassuring!  Hopefully we won't have any more days like this with him that cause us to wonder.  If it weren't for his history with some slight abnormalities in the MRI, I don't think we would have thought much about this. :)

Thank you!

[CCF Neuro, M.D.]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

There are many reasons why young children may stop walking abruptly, and it is often helpful to bring the child to his pediatrician at the time the symptoms occur. The pediatrician can assess the child for signs of injury or infection.  Often when a child complains of pain in his legs and refuses to walk, this is due to an injury that is unknown to his parents, or an infection causing inflammation (swelling) in the joints (synovitis) or muscles (myositis). Importantly, the pediatrician can examine the child for other neurological symptoms that point to a more serious condition, and make recommendations regarding pain relief or any further testing if necessary.

I am happy to hear your son’s symptoms resolved quickly and he is back to normal. Serious neurologic conditions that cause weakness or prevent walking tend not to resolve quickly on their own.  Should these symptoms recur, please bring your son to the pediatrician right away.

Regarding your son’s previous work up, I am unable to comment on the MRI without actually being able to see the images myself. However, it is reassuring that there were no tumors or other dangerous findings, and often “T2 hyperintensities” in an otherwise well, normally developing child are non-specific. If your pediatric neurologist who reviewed the images and examined your son was not concerned, then this too is reassuring.

Obtaining a timely appointment with a pediatric neurologist can be difficult. If it would be convenient for you to visit the Cleveland, OH area, you may call 866-588-2264 to inquire about a same-day appointment with our Pediatric Neurology department.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.