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JAMA Pediatrics Clinical Challenge
January 2016

A 15-Year-Old Boy With Trisomy 21 and Postoperative Weakness

Author Affiliations
  • 1 Department of Neurology, Seattle Children’s Hospital and the University of Washington, Seattle
JAMA Pediatr. 2016;170(1):85-86. doi:10.1001/jamapediatrics.2015.1677

Four days following resection of a scrotal lipoma, a 15-year-old boy with trisomy 21 presented to the emergency department with somnolence, pain, and paucity of speech with right hand and face weakness.

The scrotal lipoma resection had been performed under general anesthesia without complications. He was somnolent immediately following the procedure, and had not spoken since the day after the procedure. He was taking acetaminophen and 10 mg of oxycodone every 4 hours. Right-sided hand and face weakness developed 2 days after the procedure. His medical history was significant for trisomy 21, with mild cognitive delay and baseline dysarthria, but no aphasia. He had been self-sufficient with daily activities.

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