Approach to a child with Down syndrome (trisomy 21) Quiz: Ace Your Exams
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A 9-year-old girl with Down syndrome is brought to the clinic by her parent who noticed that she has had abnormal gait for one week. Her parents also report new onset urinary incontinence. She has no history of trauma, fever, headache, abnormal movements, or focal neurological symptoms. She has a past medical history of bronchial asthma that is well controlled with bronchodilators, and immunizations are up-to-date. Temperature is 37�C (98.6�F), pulse is 98/min, respirations are 21/min, blood pressure is 99/60 mmHg, and oxygen saturation is 98% on room air. On physical exam, ataxic gait is noted with increased muscle tone and increased deep tendon reflexes in the extremities. Cardiopulmonary and abdominal examinations are normal. Which of the following is the most appropriate next step in management?
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