Command : examine gait and do relevant examination.
6 Yr old Ahsan is conscious cooperative oriented child with slurred speech, and obvious widebased gait, not able to perform tandem walking, and positive cerebeller signs as horizontal nystagmus, intention tremors, past pointing, dysdiadokokinesia, pendular knee jerk . He is unable to do heel shin test and has hypotonia. However, there are no muscle fasciculations, bulk power and DTR are normal., and plantars are downgoing.
His cranial nerve 3,4,6 7,8,10 (visible ones) (try to remember to do all)
His pulse rate is 90/min which is reg good volume , RR is 20/min and BP is 110/70mmHg.
There is no pallor, telangiectasia in eyes, evidence of flu like symptoms , no ear discharge, mucocutaneous bleeding , no gingival hyperplasia, skin lesions or pes cavus deformity of feet.
I would like to know his growth parameters(abetalipoproteinemia) and do otoscopy and fundoscopy?
D/D :
acute cerebellar ataxia
Cerebellar SOL
Drugs: phenytoin,bezos,pheno,carbamazepine
ataxia telangiectasia
friedrichs ataxia
ac labyrinthitis
abetalipoproteinemia
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