**4.2 Clinical presentation**

Due to the variance in patient age, young children cannot report the location of pain, however, in those that are conversant most complain of back or neck pain, with radicular pain being less common [18]. Similarly, the neurological dysfunction, particularly sensory disturbance, is harder to define than in an adult population. However, most children are affected by neurological dysfunction (97%), most commonly spinal cord dysfunction, although isolated nerve root dysfunction is also reported [18].

Nearly one third of all reported cases are initially suspected of having an alternative diagnosis, most commonly Guillain-Barre syndrome, meningitis, cerebral palsy, Grisel's syndrome or an acute abdomen [18].
