Pediatric EMG Cases-Dr. Bonner Presentation

Dr. Bonner Presentation

Pdf Summary

The provided text describes a clinical case and subsequent medical proceedings involving a 4-year-old female patient who suffered an injury to her left great toe and began to exhibit abnormal walking patterns. Initial examinations from orthopedics revealed an inability to actively dorsiflex her foot to 90 degrees, although the rest of the examination was largely unremarkable. Six weeks following the onset of symptoms, the child was fitted with an Ankle-Foot Orthosis (AFO). Muscle strength testing showed severely reduced dorsiflexion and eversion, with normal plantarflexion and inversion strength. Sensory examination was difficult; however, she reported feeling on the top of her foot. <br /><br />The child's history noted early speech and fine motor delays, with eventual improvement and no gross motor issues, and she had been adopted after birth with potential prenatal marijuana exposure. Despite this, the family noted worsening conditions.<br /><br />At ten weeks, physical medicine and rehabilitation specialists documented frequent daily falls, though the patient remained active, happy, and pain-free. Reflexes were reduced, specifically on the left patellar tendon.<br /><br />Subsequent diagnostics included MRIs of the lower extremities and cervical, thoracic, and lumbar spine, alongside an electromyography (EMG) study, details of which were not elaborated in the text. After five months, the patient showed improvement under physical therapy and remained otherwise asymptomatic. After six months of symptoms, neurosurgery recommended an invasive procedure: suboccipital craniectomy, C1 laminectomy, and duraplasty.<br /><br />The text ends with a reminder for attendees to use the AANEM (American Association of Neuromuscular & Electrodiagnostic Medicine) app to provide feedback and log session attendance for continuing education credits.

Keywords

clinical case

4-year-old patient

abnormal walking

dorsiflexion

Ankle-Foot Orthosis

muscle strength

prenatal marijuana exposure

physical therapy

suboccipital craniectomy

AANEM