Slipped capital femoral epiphysis in a 5-year-old boy with cerebral palsy on valproic acid and levetiracetam for epilepsy: a case report

Abstract

This study presents a rare case of unilateral slipped capital femoral epiphysis treated surgically in a 5-year-old boy with cerebral palsy who was born at 27 weeks' gestation and developed grade III intraventricular haemorrhage and periventricular leucomalacia and was on antiepileptic drugs, including valproic acid and levetiracetam for >3 years. The patient had no history of endocrine, renal, and significant familial diseases.

Keywords: cerebral palsy; hip pain; levetiracetam; slipped capital femoral epiphysis; valproic acid.

Figure 1

Pelvic anterior–posterior radiograph showing coxa valga deformity in the left hip.

Figure 2

Pelvic anterior–posterior radiograph showing SCFE in the right hip, with Klein’s line not intersecting the capital femoral epiphysis

Figure 3

Pelvic frog-leg lateral view radiograph showing Southwick’s slip angle 50^° in the right hip.

Figure 4

Pelvic anterior–posterior radiograph immediately after in situ fixation with single cannulate screw.

Figure 5

Six weeks following post-operative fixation: (A) pelvic anterior–posterior radiograph and (B) pelvic frog-leg lateral view radiograph.

Figure 6

Pelvic anterior–posterior radiograph, 3 months following post-operative fixation.

Figure 7

Pelvic anterior–posterior radiograph, 15 months following post-operative fixation.

Figure 8

Right hip anterior–posterior radiograph, 36 months following post-operative fixation.