Caloric requirements of a spastic immobile cerebral palsy patient: a case report.
This article documents the reduced caloric requirements for a spastic, immobile, cerebral palsy patient. We report an 11-year-old immobile, spastic, quadriparetic patient who remained obese despite receiving less than one half of the recommended basal caloric requirements for age. Basal metabolic rate was determined by indirect calorimetry using a Sensor Medics 2900 instrument. Standard reference sources indicate that an able-bodied 11-year-old child of comparable height requires 1,493 kcal/d for support of basal metabolic functions. Our patient was followed for 8 weeks on reduced calories and assessed for adequacy of diet by nitrogen balance studies and other appropriate parameters. Our data suggest that a subset of severely impaired children with cerebral palsy may require much less in total kilocalories per day for nutritional support than previous studies would indicate.