Weakness and Paralysis (Assessment & Diagnosis) — 4mo Infant | Pediatric Infectious | MCCQE1 Q#12124

MCCQE1 Question #12124

Dimension of Care

Acute Care

Activity

Assessment & Diagnosis

Objective

Weakness and Paralysis

Section

Pediatrics

Subject

Pediatric Infectious

Last updated: February 2026
A 4-month-old term infant is brought to a community emergency department because of progressive floppiness over 2 days. The parents report a weak cry, poor feeding with diminished suck, and constipation for 4 days. They recently started adding honey to the infant’s cereal. There is no fever or recent illness. On exam, the infant is alert but markedly hypotonic with head lag. Cranial nerve exam shows weak suck and decreased gag, with diffusely decreased deep tendon reflexes and intact sensation. What is the most likely cause of this infant’s hypotonia?
Full answer analysis and choices are available inside the practice session.