Dr Smita Patil Zope

29/01/2025

All the time it was important for the parents to understand this weakness may progress and we have to monitor him. The fathers smile was gone. Next day the child also developed weakness of trunk muscles so he was unable to sit up independently. Further he was also unable to swallow and developed what we call as the bulbar palsy in medical language forcing us to put a feeding tube lest he may aspirate if fed orally. The mother and father both were looking desperate and it was difficult for them to understand that why the weakness was progressing.
Fortunately there was no further progression of weakness and over next week we could remove his feeding tube. Mast AP was looking happy to take food orally again. Daily exercises were started and child was sent home as it was his 4th birthday with a promise to do daily physiotherapy. 2 months later mast AP is standing and walking before me independently. The joy on his face and smile on the parents’ lips is the picture I want to remember lifelong.

29/01/2025

A father’s nightmare
A 4 years boy walked with his father’s support in my OPD on a Sunday evening. Child was walking with a limp on one side and on smiling his face was getting deviated to one side. This boy looked cheerful and healthy. Let’s say his name was mast AP.
Mast AP was a mature boy for his age and just started going to playschool this year. He was the only child of this couple. So obviously the father was very anxious. He was admitted and some tests were ordered including MRI of Brain and Spine. These tests did not reveal any abnormality. Over the night, the walking problem progressed to involve his other leg too and he was unable to walk without help. We ordered a nerve conduction study and as per my expectation it turned out to be Guillian Barre Syndrome. He was started on expensive immunoglobulin treatment.
Guillian Barre Syndrome(GBS) is a disease caused due to immune dysfunction. Wherein body s own immune system attacks its nerves and makes the person weak. It may also involve the facial muscles, swallowing muscles or muscles of respiration making the patient difficult to breathe and needing ventilator support. The exact cause of GBS is unknown but the preceding history of viral illness is found in most patients. Post covid also there splurge in cases of GBS potentiating the immunological dysfunction as a cause. There is no known cure for the disease. Only symptomatic treatment options are available which will reduce duration of illness. Although most people recover completely very few can have fatal course. Recovery may take 3-6 months and can be to a variable extent. Timely intervention can help to stop further progression to non ambulatory state.
All the time it was important for the parents to understand this weakness may progress and we have to monitor him. The fathers smile was gone. Next day the child also developed weakness of trunk muscles so he was unable to sit up independently. Further he was also unable to swallow and developed wh

22/12/2024

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