A 3.

5 year old male child with normal growth and development was admitted in PICU with acute
severe asthma. He had intermittent asthma for the past one and a half years. He was fully
immunized including pulse polio immunizations. He had three days of ICU stay and was given
nebulization with salbutamol, ipratropium and steroids, ampicillin, IV methyl prednisolone and
MgSO4 infusion. He responded and did not require any ventilator support or muscle relaxants. On
the 4th day of ...
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Asia Abdulla ??
Like Reply 1 3 November at 22:51

Yossef Yossef Mustafa Acute exacerbations of asthma are common in children, but limb weakness after such
exacerbations is very unusual. Hopkins' syndrome, a poliomyelitis-like illness associated with asthma, is seldom
reported in the literature. We describe a child with weakness of the lower limbs after an asthmatic attack. The clinical
profile, possible pathogenesis,
Like Reply 1 Yesterday at 01:33

Mahmoud Said Asthmatic Amyotrophy (Hopkins Syndrome) Sudden flaccid paralysis of one or more limbs,
resembling poliomyelitis, may occur during recovery from an asthmatic attack. All affected children had previously
received poliomyelitis vaccine. The etiologic mechanism for this syndrome is unknown. Infection by a neurotropic virus
other than poliovirus is a possibility. Adenovirus, echovirus, and coxsackievirus have been isolated from stool, throat,
or cerebrospinal fluid in some cases Age at onset is from 1 to 11 years. The interval between the asthmatic attack and
the paralysis is 1 to 11 days, with an average of 5 days. Monoplegia occurs in 90 %, with the arm involved twice as
often as the leg. The other 10 % have hemiplegia or diplegia. Meningeal irritation is not present. Sensation is intact
but the paralyzed limb is painful in half of cases. Recovery is incomplete, and all affected children have some degree
of permanent paralysis. Diagnosis. Asthmatic amyotrophy is primarily a clinical diagnosis based on the sequence of
events. The diagnosis requires distinction from paralytic poliomyelitis and idiopathic brachial neuritis. The basis for
excluding paralytic poliomyelitis is normal cerebrospinal fluid in asthmatic amyotrophy. A few white blood cells may be
present in the cerebrospinal fluid but never to the extent encountered in poliomyelitis, and the protein concentration is
normal. EMG during the acute phase shows active denervation of the paralyzed limb, but the pattern of denervation
does not follow the radicular distribution expected in a brachial neuritis. Management. Gabapentin and pregabalin
may be helpful in controlling neuropathic pain. Other analgesia may be needed. , physical and occupational therapy
are often required.
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