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Gold standard case presentation
Cerebral palsy and scoliosis of the spine
Cerebral palsy encompasses a spectrum of neurological deficits, due to neurological damage either ante-natally, intra-partum or early post-partum.
Clinical symptoms and signs:
- Delayed developmental milestones
- Jerky, random, uncoordinated movements
- Muscle spasms
- Tip-toe walking in infancy
Scoliosis is the curvature, sideways of the spine, which is common in cerebral palsy, which can lead to unbalanced shoulders and similar problems in the waist and hip. Scoliosis causes a restrictive lung defect of the lung due to a failure of complete rib expansion. This leads to reduced lung volumes. Sometimes if the defect is extrinsic, different positions can be of benefit.
Patients often feel breathless, especially upon exertion, but with an essentially normal physical lung examination. In mild to moderate scoliosis, the lung function will be mostly normal. Only in severe cases will it reduce the flow-volume curve, with a reduced total lung capacity.
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Question 1 of 4
1. Question1 point(s)
What do you think this patient’s underlying neurological diagnosis is?CorrectIncorrect
Question 2 of 4
2. Question1 point(s)
What musculoskeletal abnormality does this gentleman have that may affect his respiratory function?CorrectIncorrect
Question 3 of 4
3. Question1 point(s)
How would you describe this patient’s breath sounds?CorrectIncorrect
Question 4 of 4
4. Question1 point(s)
What defect would you expect to see on this patient’s spirometry if his scoliosis was clinically significant?CorrectIncorrect