A 16-year-old sustains an acute C7 spinal cord injury in a diving accident. The medical team is planning deep venous thrombosis (DVT) prophylaxis. In addition to mechanical prophylaxis, which management strategy is recommended for this specific patient?
A 7-year-old with spastic quadriplegic cerebral palsy is evaluated for severe generalized spasticity that interferes with care and positioning. Oral medications have provided minimal benefit with significant sedation. The family is considering an intrathecal baclofen pump. What is a critical piece of safety education the family must receive regarding this treatment?
A 9-year-old boy is recovering from a severe traumatic brain injury in the intensive care unit. He begins to have paroxysmal episodes of tachycardia, tachypnea, hyperthermia to 39.5°C (103.1°F), diaphoresis, and dystonic posturing, often triggered by repositioning. Which medication is reported to be ineffective for managing these episodes of paroxysmal sympathetic hyperactivity (PSH)?
A 4-month-old infant with an extended Erb palsy (C5-C7) undergoes electrodiagnostic studies. Nerve conduction studies show a normal sensory nerve action potential (SNAP) recordable from the lateral forearm (lateral antebrachial cutaneous nerve). However, on clinical examination, the infant shows no response to a pinprick in that same sensory distribution. What is the most likely interpretation of this finding?
A 3-year-old boy presents to the emergency department after falling from a playground slide. His mother reports he was dazed for a few minutes but did not lose consciousness. On examination, his Glasgow Coma Scale score is 15. What is the single most common cause of traumatic brain injury (TBI) in this child’s age group?
A newborn is diagnosed with a meningomyelocele at the L3 spinal level. The parents are anxious about their child’s future mobility. Based on this specific lesion level, what is the most likely ambulatory outcome for this child during their school-age years?
A 6-year-old with a high cervical spinal cord injury has poor trunk control and requires a wheelchair for mobility. The seating system has been customized with a headrest and lateral supports. What is the primary function of the seating system (the seating orthosis) itself, considered separately from the wheelchair frame?
A 15-year-old with cerebral palsy and moderate functional limitations is increasingly isolated. The healthcare team is developing a health promotion program to address his well-being. Which of the following statements about physical activity for children with disabilities is accurate?
A 14-year-old with a T4 spinal cord injury develops a pounding headache, flushing of the skin above his chest, and a blood pressure of 140/90 mmHg (his baseline is 95/60 mmHg). The first action taken was to elevate the head of the bed. What is the most appropriate immediate next step in managing his autonomic dysreflexia?
An infant born with shoulder dystocia is diagnosed with a complete C5-T1 birth brachial plexus palsy and an associated Horner syndrome. A specialty consultation is planned for this Narakas type IV injury. At what age should primary nerve surgery ideally be considered for this infant?
