Dr. Abhaya Kant Tewari
Neurology
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hello doctor,
This query concerns my dear friend's son, a 14-year-old who has suddenly developed dystonia in his left arm. I apologize for not having a detailed history regarding the case, as my friend and his son are abroad. However, their doctor has suggested his problem may be genetic even though no one in his family has similar complaints. Please go through his medical records, which are attached, sir. Do you concur with the assessment of his doctors? As of now, they have suggested physiotherapy for his problems. Sir, could you suggest neurorehabilitation or a higher centre in our country which my friend could consult for further management of this problem. Thank you.
Hi,
Welcome to icliniq.com.
To summarize the facts in common terms, the first consultation shows (attachments removed to protect the patient's identity) that there is predominant wasting of the left hand affecting the parts below the elbow more, which is associated with weakness (not confined to the distribution of one particular nerve), no sensory involvement is there. Though he has mentioned dystonia (irresistible posturing of parts due to contraction of a group of muscles), the patient has no complaint, so it is neither a muscle nor a nerve disease. It originates in anterior horn cells, the cell where the fibers of nerve originate in the spine affecting only the motor nerves and not affecting the sensation. In a broad group, it is suggestive of localized ANT (anterior) horn cells. A more detailed history and careful look at the patient will probably clear the picture and prognosticate.
Regards.
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Neurology
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