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Her Mother Brings a 24-Month-Old Daughter to the Office Because

Question 148

Multiple Choice

Her mother brings a 24-month-old daughter to the office because she is afraid of walking. According to the mother, "When she walks, she appears wobbly. She was walking so well until a few weeks ago, and now she's always falling over things." During the examination, the patient sits on the floor and claps her hands. She makes chattering sounds instead of answering inquiries. When her mother pushes her to move, the patient pulls herself up and walks with an uneven pace. The rest of the test is normal, except for abrasions on both knees caused by numerous falls, as explained by her mother. Both height and weight are in the 50th percentile. At a checkup 6 months ago, the patient had been saying 1- or 2-word phrases and walking without aid.  Which of the following neuropathic changes most likely underlies this patient's presentation?


A) Accumulation of hyperphosphorylated tau protein
B) Arrested brain development
C) Copper deposition in the lenticular nucleus
D) Cortical hyperexpansion
E) Hypoxic ischemic injury during delivery

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