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Bilateral Upper Limb Weakness and Stridor
Raja Ram, MBBS;
Anne Reaveley, MBBS;
Jon Dorling, MBChB;
Julian Eason, MHSc
Arch Pediatr Adolesc Med. 2002;156:941-943.
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Clinical Presentation: A 4-week-old girl had difficulty breathing, reduced feeding, and upper
limb weakness. She was born at 39 weeks' gestation by forceps after a failed
ventouse. At birth, minimal resuscitation was needed, with suction and facial
oxygen. Results of subsequent examinations after birth were normal. At 2 weeks
of age, she developed a dry cough, which gradually worsened, and on the day
of admission, her breathing became increasingly noisy and she developed apneic
episodes. There had been no exposure to cigarette smoke or pets.
Dr Eason: The history of cough developing in the preceding 2 weeks and subsequent
lower respiratory tract signs culminating in apnea is highly suggestive of
respiratory syncytial virus bronchiolitis. Apnea is a common clinical finding
in young infants with bronchiolitis. Noisy breathing could, however, be confined
to the upper respiratory tract, and the . . . [Full Text of this Article] COMMENT
From the Jenny Lind Children's Department, Norfolk and Norwich University
Hospital Trust, Norwich, England.
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