Reversible Cerebral Atrophy in Infantile Tremor Syndrome
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Case
A 10-month-old exclusively breastfed female child was admitted with the complaints of abnormal rhythmic jerky movements of both hands, feet, tongue and head nodding for 6 days prior to admission. Movements were suggestive of coarse resting tremors. Child was having moderate wasting and normal height for age. Head circumference was below –2 SD for age and sex. Developmentally, child was able to sit without support, had a palmar grip, and was able to tell monosyllables before the onset of disease (DQ 92±5). At admission, she was not able to sit without support and only cooing was present (DQ 44±5). Blood investigations suggested predominantly microcytic hypochromic anemia with normal serum levels of albumin and Vitamin B12. MRI brain suggested mild diffuse cerebral atrophy (Fig.1a and 1b). Nutritional rehabilitation was continued at home after 5 days of admission. Follow-up of the patient was done after 17 months when she had normal development for her age (DQ 84±5). Anthropometrically she had normal weight for age, and length. Head circumference was still below -2 SD. MRI scan of brain showed improvement in cerebral atrophy with no sulcal prominence or ventricular enlargement....

http://www.indianpediatrics.net/aug2016/aug-727-729.htm
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