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BMJ Case Reports 2012; doi:10.1136/bcr-2012-007533

Remarkable recovery in an infant presenting with extensive perinatal cervical cord injury

  1. A K Gururaj2
  1. 1Department of Paediatric Neurology, Latifa Hospital, Dubai, United Arab Emirates
  2. 2Department of Paediatric Neurology, Latifa Hospital, Dubai, United Arab Emirates
  1. Correspondence to Dr Israr Ul Haq, israrulhaq87{at}gmail.com

Summary

Cervical-cord damage is a complication of a difficult delivery, and results in spinal shock with flaccidity progressing to spastic paralysis. Conventionally, outlook for such patients is extremely poor and most will recover only slightly from quadriplegia and autonomic dysfunction. Here, we report a case in which the extent of damage considerably contrasted with the outcome and recovery. A full-term baby girl born by difficult vaginal delivery displayed bilateral flaccid paralysis of the lower limbs with absent spontaneous movements, weakness of both upper limbs, hyporeflexia in all limbs and axial hypotonia. MRI of cervicothoracic spine exhibited raised signal intensity in the dorsal aspects of C7 to T1 signifying myelopathy. MRI at 4 months revealed a near-total transection of the cervical cord. However, at 6 months, the child could move all lower limbs independently with a marked increase in power. There was no spasticity, wasting or incontinence. Reflexes had also returned.

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