June 2026 Pediatric Lecture Series: Interesting Peds Rehab Case Discussion-Session Recording

Video Transcription

Video Summary

The meeting featured two Seattle Children’s pediatric rehab case presentations.<br /><br />The first case was a 13-year-old boy with autism and Dravet syndrome who developed fever, acute lower-extremity weakness, inability to walk, and urinary retention. Initial concerns included UTI/urologic disease, Guillain-Barré syndrome, or medication side effects. Basic labs, cultures, renal ultrasound, and spine MRI were unrevealing. A limited EMG showed diffuse motor-predominant axonal changes, and a later sedated EMG demonstrated multifocal mixed demyelinating and axonal sensory-motor neuropathy involving upper and lower extremities. Because of the atypical course, neurology treated him as possible CIDP with IVIG, and he gradually improved with therapy, taking steps again months later. The presenters also reviewed literature suggesting peripheral nerve involvement can occur in Dravet syndrome.<br /><br />The second case involved a 16-year-old ambulatory boy with Duchenne muscular dystrophy who developed persistent left knee pain, later radiating to the hip and worsening at night. X-rays, MRI, and lumbar/pelvic imaging were initially non-diagnostic. Further review and CT identified a small lytic lesion in the left proximal femoral neck, most consistent with osteoid osteoma or non-ossifying fibroma. Naproxen significantly improved his pain, supporting osteoid osteoma. Radiofrequency ablation with prophylactic fixation was discussed, but the family chose continued medical management. The case highlighted the importance of broad differentials, low imaging thresholds in DMD, and multidisciplinary collaboration.

Keywords

Seattle Children’s

pediatric rehab

Dravet syndrome

CIDP

peripheral neuropathy

Duchenne muscular dystrophy

osteoid osteoma

radiofrequency ablation