Atlanto-occipital and atlanto-axial instability in children with Down Syndrome

Thirty-six children with Down syndrome, between two-and-one-half and 13 years of age, were evaluated for instability of the cervical spine, in order to determine the prevalence of upper cervical spine instability in Saudi children with this condition. Nine patients exhibited abnormal cervical spine movement. Eight patients had atlanto-occipital instability and three had atlanto-axial instability. None of the nine patients with abnormal cervical spine movements developed any neurological deficit. Our survey confirms the data from the literature that there is a high incidence of cervical spine instability in children-with Down syndrome

Child abuse in Saudi Arabia: Report of ten cases

Ten abused children under five years of age [four males, six females] were seen in King Faisal Specialist Hospital and Research Centre [KFSH and RC] between 1986G and 1992G. Two children died, five had serious injuries and three had moderately severe injuries. In one of the fatalities, the diagnosis was not suspected until four years after death, when her sister was diagnosed as a case of child abuse. Six children suffered varying degrees of physical neglect and abuse and sexual abuse. The remaining four children had Munchausen syndrome by proxy. Parentally induced illness should therefore be considered in the differential diagnosis of unusual illness with bizarre features, even if the parents' behavior appears normal