Practical Neurology

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Practical Neurology 2004;4:56-57; doi:10.1111/j.1474-7766.2004.08-187.x
Copyright © 2004 by the BMJ Publishing Group Ltd.

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A Difficult Case

Not Just a Child With Simple Learning Disability: Beware the Opercular Syndrome

Zuhal Yapici

Department of Neurology, Division of Child Neurology, Istanbul University Facuty of Medicine, Capa 34390, Istanbul, Turkey; Email: quitpast{at}hotmail

EXTRACT

An 8-year-old girl with a speech disorder was admitted to our Child Neurology Department. She had been born at term after an uneventful pregnancy, but on delivery she did not start to cry and she was cyanotic. Her APGAR score was 4 within the first minute and rose to 7 in 10 minutes. Head circumference, weight and height were normal. There was no hypotonicity and she had no difficulty in sucking in the Neonatal Intensive Care Unit. There were no convulsions or episodes of apnoea.

Developmental milestones such as holding her head upright, sitting and walking unsupported were all passed on time. She started saying single words at the age of two years, but she did not get beyond this. At the age of five, she still had the speech difficulty but on examination the child was not considered to have any additional clinical problems other than being a little ...

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