What is the differential diagnosis for a child with acute lower extremity paralysis ( inability to move legs)?

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Differential Diagnosis for a Child Unable to Move Their Legs

Single Most Likely Diagnosis

  • Guillain-Barré Syndrome: An autoimmune disorder that is a common cause of acute flaccid paralysis in children, often following a viral infection. It typically presents with ascending paralysis, starting in the lower limbs.

Other Likely Diagnoses

  • Trauma: Spinal cord injuries or fractures can cause paralysis or weakness in the legs, depending on the level and severity of the injury.
  • Infections: Such as meningitis or spinal epidural abscess, which can compress or infect the spinal cord, leading to leg weakness or paralysis.
  • Transverse Myelitis: An inflammatory condition that affects the spinal cord, leading to symptoms like leg weakness, paralysis, or loss of sensation.

Do Not Miss Diagnoses

  • Spinal Cord Compression: Due to conditions like tumors, abscesses, or hematomas, which require immediate medical attention to prevent permanent damage.
  • Botulism: A rare but potentially life-threatening illness caused by a toxin that can lead to muscle weakness, paralysis, and respiratory issues.
  • Tick Paralysis: A rare condition caused by the bite of certain ticks, leading to ascending paralysis that can mimic Guillain-Barré Syndrome.

Rare Diagnoses

  • Spinal Muscular Atrophy (SMA): A genetic disorder that affects the nerve cells responsible for controlling voluntary muscle movement, leading to muscle weakness and wasting.
  • Acute Flaccid Myelitis (AFM): A rare condition that affects the spinal cord, causing muscle weakness and paralysis, often in children.
  • Neuromuscular Disorders: Such as muscular dystrophy or congenital myopathies, which can present with progressive muscle weakness and may initially affect the legs.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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