Foreign body ingestion can result in movement disorder
Olugbenga Akingbola, M.D., from the Tulane Lakeside Hospital for Women and Children in Metairie, La., and colleagues describe the case of a previously healthy 10-month-old girl who was admitted to the pediatric intensive care unit for acute onset of a movement disorder with recurrent bouts of irritability with arching, head extension, and lethargy.
The researchers ruled out possible diagnoses, including meningitis, status epilepticus, space occupying lesions, and toxic ingestions, because of negative cerebrospinal fluid analysis, normal electroencephalogram, and negative results on other ancillary tests. Due to recurrent episodes of arching and lethargy, intussusception was considered a probable diagnosis, and an abdominal radiograph was obtained on the second day of admission. A 15-mm radiopaque foreign body was revealed in the right lower quadrant, corresponding to the anatomic location of the ileocecal valve. After spontaneously passing a 1.5 cm by 1 cm rock in her stool on the third day of admission the patient made an uneventful recovery.
"This case highlights the need for a high index of suspicion for unwitnessed ingestion of a foreign body in a previously healthy preschool child with sudden onset of a movement disorder," the authors write.
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