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Unusual association of diseases/symptoms
Acute functional deterioration in a child with cerebral palsy
  1. Elizabeth Smyth1,
  2. Chandrasekaran Kaliaperumal2,
  3. Jane Leonard1,
  4. John Caird2
  1. 1Department of Paediatrics, Children's University Hospital, Temple Street, Dublin, Republic of Ireland
  2. 2Department of Neurosurgery, Children's University Hospital, Temple Street, Dublin, Republic of Ireland
  1. Correspondence to Chandrasekaran Kaliaperumal, ckaliaperumal{at}


We describe a case of acute functional deterioration in a 13-year-old girl with severe spastic diplegia (GMFCS III) and a new diagnosis of diffuse intrinsic pontine glioma (DIPG). She presented with acute deterioration in mobility and motor function over 1 month, which was associated with dysarthria, dysphagia and behavioural change. Her mother had noticed subtle functional deterioration over the 2 months prior to this. Her physiotherapist who was concerned about her acute functional deterioration referred her for emergency review. Neurological imaging revealed a diffuse pontine lesion consistent with DIPG. She was subsequently referred to oncology. She deteriorated further, clinically, over the next few days and following discussion with the team; her family opted for palliative treatment, given the poor prognosis associated with DIPG.

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