Pressure palsy
Joe
Description
Collection
Title:
Pressure palsy
Creator:
Joe
Date:
3/10/2001
Text:
I evaluated an 8yr old girl friday for left leg bracing. A
neurologist's diagnosis is pressure palsy. I have never heard of it.
Searching in all my wife's neurology texts I can't locate any reference.
The girl's father said the doctor said the disorder would last only
about 6 ot 8 weeks. But no guarantee came with that opinion.
Her history is that 6 weeks ago she fell out of a tall loft type bed
while sleep walking. Her father said it was about a five foot fall.
Prior to the fall she was an active child using both legs as a normal
bodied person. Immediately she informed her parents that her leg did not
listen to her. She also hurt her foot in the fall and points to painful
location on the plantar surface at the transverse arch. She fell again
two weeks ago. She now sleeps on the floor!
She is not walking, her father carries her on his back. They tried
crutches for a few days but she fell allot. Her father would not let her
stand for me because of the foot pain. I was told that X-rays are
negative with regard to fractures of the spine, hip, leg, knee and foot.
ROM muscle testing on the uninvolved side's joints from foot to hip is
good. ROM on the involved side is an interesting story. As I ran the
limb segments through ROM they were full, no pain is associated. No
clonus when quick flexion or extension of the segment is tested. When
asked to hold a position to test the strength against resistance she
tremors throughout the involved side, hip to foot, strength fades
quickly. I did not hold the position for longer than a few seconds, so I
don't know if the tremors would subside over a longer period. A slight
tremor or wiggle is noticed on the uninvolved right side at the foot
when testing the left.
Normally we don't want to lock up a joint but I felt that doing so may
be the best alternative. I was not able to test walking using a knee
immoblizer and cam walker as I wanted to. I'm tempted to call her back
and convincing them to try it. She has to weight bear sometime.
Putting her in a long leg brace seems overkill when the problem may
resolve itself in a few weeks. Then again it may not. Putting her in a
double adjustable AFO so that we can vary the amount of motion with rods
and springs won the toss. What other alternatives might I address?
Tests?
thanks in advance
Joe Harvey, BSci O&P
neurologist's diagnosis is pressure palsy. I have never heard of it.
Searching in all my wife's neurology texts I can't locate any reference.
The girl's father said the doctor said the disorder would last only
about 6 ot 8 weeks. But no guarantee came with that opinion.
Her history is that 6 weeks ago she fell out of a tall loft type bed
while sleep walking. Her father said it was about a five foot fall.
Prior to the fall she was an active child using both legs as a normal
bodied person. Immediately she informed her parents that her leg did not
listen to her. She also hurt her foot in the fall and points to painful
location on the plantar surface at the transverse arch. She fell again
two weeks ago. She now sleeps on the floor!
She is not walking, her father carries her on his back. They tried
crutches for a few days but she fell allot. Her father would not let her
stand for me because of the foot pain. I was told that X-rays are
negative with regard to fractures of the spine, hip, leg, knee and foot.
ROM muscle testing on the uninvolved side's joints from foot to hip is
good. ROM on the involved side is an interesting story. As I ran the
limb segments through ROM they were full, no pain is associated. No
clonus when quick flexion or extension of the segment is tested. When
asked to hold a position to test the strength against resistance she
tremors throughout the involved side, hip to foot, strength fades
quickly. I did not hold the position for longer than a few seconds, so I
don't know if the tremors would subside over a longer period. A slight
tremor or wiggle is noticed on the uninvolved right side at the foot
when testing the left.
Normally we don't want to lock up a joint but I felt that doing so may
be the best alternative. I was not able to test walking using a knee
immoblizer and cam walker as I wanted to. I'm tempted to call her back
and convincing them to try it. She has to weight bear sometime.
Putting her in a long leg brace seems overkill when the problem may
resolve itself in a few weeks. Then again it may not. Putting her in a
double adjustable AFO so that we can vary the amount of motion with rods
and springs won the toss. What other alternatives might I address?
Tests?
thanks in advance
Joe Harvey, BSci O&P
Citation
Joe, “Pressure palsy,” Digital Resource Foundation for Orthotics and Prosthetics, accessed November 2, 2024, https://library.drfop.org/items/show/216166.
