Annals of emergency medicine
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Presented is the case report of a toddler who suffered delayed-onset paraplegia after a motor vehicle accident. An improperly used adult lap belt is postulated as the etiology causing a probable vascular event with ischemic injury to the distal cord; however, recurrent cord injury from presumed occult spinal instability was a possible explanation. This case highlights that the syndrome of spinal cord injury without radiographic abnormality can present subtly (in this case, foot "pain"), that full neurologic manifestations can be delayed, and that good neurologic recovery is possible.