Vignettes for Pediatric Neurology Vignette #1 10-month-old boy referred by pediatrician for evaluation of developmental delay Birth History • Normal • F T NSVD • Birth Weight: 7 lbs. • Nursery Stay: 2 days Developmental History • Smiled at 2 months • Head control at 4 months • Rolled over at 6 months • Not able to sit without support as yet • Babbles and interacts well for age Physical Exam • Ht, Wt, & HC are in 50% • MS: awake, alert & happy • CrN: II-XII Normal • Motor: Non-focal • Tone: Moderate to Severe Hypotonia • DTR's: Difficult to elicit • Dev: o Unable to sit without support o Good social interaction o Babbling o Holds objects in his hands o Does not reach for objects
Discuss localization, diagnosis, management and prognosis