ABSTRACT
Diaphragmatic flutter (DF) is an unusual movement disorder with involuntary and repetitive contractions of the diaphragm with or without other abdominal muscle involvement. The disorder is known to occur across all ages including newborns. The etiology is diverse and so are the therapeutic options. Reaching an etiological diagnosis is considerably delayed. Response to therapy is variable and is governed by the underlying etiology. We describe three children with diaphragmatic flutter. The etiology was diverse with unrelated pathologies such as hypocalcemia, striatal necrosis, and idiopathic. All three children responded promptly and completely to calcium, high dose thiamine and biotin, and clonazepam, respectively. Our case series underscores the importance of clinical identification of such rare movement disorders. It also emphasizes that directed etiological evaluation may lead to successful amelioration of DF which is otherwise considered refractory to therapy.
Subject(s)
Hypocalcemia , Movement Disorders , Infant, Newborn , Child , Humans , DiaphragmABSTRACT
¹⁸F-DOPA PET/CT is commonly done in patients with persistent hyperinsulinemic hypoglycemia of infancy (PHHI) to look for any focal lesion in the pancreas.We present the findings in a 20-day-old neonate with PHHI who underwent ¹⁸F-DOPA PET/CT. The scan showed diffuse uptake in the pancreas with no focal lesion, physiologic excretion into the genito-urinary system, and interestingly tracer accumulation was seen in the inferior vena cava and ilio-femoral veins which is a non-physiological site for tracer accumulation. The uptake corresponded to a large venous thrombus which was confirmed by a venous Doppler.
Subject(s)
Humans , Infant, Newborn , Congenital Hyperinsulinism , Pancreas , Positron Emission Tomography Computed Tomography , Thrombosis , Veins , Vena Cava, InferiorABSTRACT
¹â¸F-DOPA PET/CT is commonly done in patients with persistent hyperinsulinemic hypoglycemia of infancy (PHHI) to look for any focal lesion in the pancreas.We present the findings in a 20-day-old neonate with PHHI who underwent ¹â¸F-DOPA PET/CT. The scan showed diffuse uptake in the pancreas with no focal lesion, physiologic excretion into the genito-urinary system, and interestingly tracer accumulation was seen in the inferior vena cava and ilio-femoral veins which is a non-physiological site for tracer accumulation. The uptake corresponded to a large venous thrombus which was confirmed by a venous Doppler.
