Differential Diagnosis of Autonomic Disturbances and Recognition by History and Physical Findings

Syncope ◽  
2020 ◽  
pp. 125-133
Author(s):  
Martina Rafanelli ◽  
Andrea Ungar
Keyword(s):  
Differential Diagnosis ◽  
Autonomic Disturbances ◽  
Physical Findings

Facial Paralysis in Children: Differential Diagnosis

1981 ◽  
Vol 89 (5) ◽  
pp. 841-848 ◽  
Author(s):  
Mark May ◽  
Thomas J. Fria ◽  
Frank Blumenthal ◽  
Hugh Curtin
Keyword(s):  
Hearing Loss ◽  
Differential Diagnosis ◽  
Herpes Zoster ◽  
Facial Paralysis ◽  
Positive Family History ◽  
Pseudobulbar Palsy ◽  
Slow Progression ◽  
Facial Edema ◽  
Physical Findings ◽  
Fissured Tongue

The differential diagnosis in 170 patients between birth and 18 years of age is reviewed. There are a number of obvious physical findings and historical features that allow one to make a diagnosis rather quickly. Pain, vesicles, a red pinna, vertigo, and sensorineural hearing loss suggest herpes zoster oticus. Slow progression beyond three weeks, recurrent facial paralysis involving the same side, facial twitching, weakness, or no return of function after six months indicate a neoplasm. Bilateral simultaneous facial paralysis indicates a cause other than Bell's palsy, such as Guillain-Barré syndrome, pseudobulbar palsy, sarcoidosis, and leukemia. Recurrent facial paralysis associated with a fissured tongue, facial edema, and a positive family history should suggest Melkersson-Rosenthal syndrome.

scholarly journals A Case Study of Intractable Vomiting with Final Diagnosis of Neuromyelitis Optica

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Rachel Bramson ◽  
Angela Hairrell
Keyword(s):  
Differential Diagnosis ◽  
Rural Community ◽  
Neuromyelitis Optica ◽  
Neurological Disorder ◽  
Tertiary Care ◽  
Final Diagnosis ◽  
Neurological Symptoms ◽  
Nausea And Vomiting ◽  
Physical Findings

This case study presents a patient living in a suburban/rural community who received appropriate referral to secondary and tertiary care for nausea and vomiting, accompanied by waxing and waning neurological symptoms, yet proved difficult to diagnose. This patient is presented to draw attention to a rare neurological disorder which should be included in the differential diagnosis of nausea and vomiting with some key neurological complaints, even in the absence of physical findings.

Pseudoneoplasms of the Nervous System

2010 ◽  
Vol 134 (3) ◽  
pp. 404-416
Author(s):  
Kliment Donev ◽  
Bernd W. Scheithauer
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Clinical Picture ◽  
Correct Diagnosis ◽  
Molecular Genetic ◽  
Data Sources ◽  
Pertinent Literature ◽  
Presenting Symptoms ◽  
Radiation Induced ◽  
Physical Findings

Abstract Context.—Pseudoneoplasms of the nervous system vary greatly in nature. Ranging from inflammatory to autoimmune, infectious, malformative, reactive, degenerative, and radiation induced, they all mimic true tumors. Thus, they have the potential to mislead clinicians, radiologists, and pathologists alike. Their clinical and/or neuroimaging and histologic features are readily misinterpreted as tumor. Knowledge of the pitfalls is essential to avoid mismanagement, specifically overtreatment. In such instances, pathologists must take the entire clinical picture into consideration, acquainting themselves with presenting symptoms, physical findings, and neuroimaging. Objective.—To present 10 examples of pseudoneoplasms of the nervous system, analyze the basis for their mimicry, and discuss their differential diagnosis. Data Sources.—Review of the pertinent literature related to pseudoneoplasms of the nervous system and review of the consultation files of one of the authors (B.W.S.). Conclusions.—The identification of tumor mimics may be difficult under the best of circumstances, and maintaining a broad differential diagnosis as well as application of a variety of immunocytochemical and occasionally ultrastructural and/or molecular genetic methods is essential to arrive at a correct diagnosis.

Peripheral Lymphadenopathies in Childhood: Experience at a Pediatric Oncology Department in Turkey

2020 ◽  
pp. 66-73
Author(s):  
Tuğçe Kalın Güngör ◽  
Handan Uğur Dinçaslan ◽  
Emel Cabi Ünal ◽  
Nurdan Taçyıldız ◽  
Leman Gülsan Yavuz
Keyword(s):  
Differential Diagnosis ◽  
Clinical Laboratory ◽  
Laboratory Findings ◽  
Abnormal Chest ◽  
Malignant Group ◽  
Chest X Ray ◽  
Systemic Symptoms ◽  
Reactive Hyperplasia ◽  
Physical Findings ◽  
Benign Group

Introduction: Palpable lymph nodes are very common physical examination findings in childhood, and sometimes it can be challenging to say if it is benign or malignant. Objectives: This retrospective study evaluated 157 children admitted to an oncology department because of lymphadenopathy and aimed to determine the clinical, laboratory, and epidemiologic data valuable for differential diagnosis. Materials and Methods: One hundred fifty-two cases were analyzed, which were defined as either malignant or benign by the etiology. The benign cases were also defined to three groups as ‘viral lymphadenopathy’, ‘bacterial lymphadenopathy’, and ‘other reactive lymphadenopathy’. Results: A specific cause for lymphadenopathy was documented in 61 (40,1%) cases. Of 152 cases, benign causes were detected in 133 (87,5%), and malignant causes were detected in 19 (12,5%) cases. The most frequent cause in the benign group was reactive hyperplasia (59,8%) and in the malignant group was lymphoma (7,3%). A biopsy was performed from 19 of the cases for diagnosis. Malign causes were detected in 12 (58%), and benign causes were detected in the remaining 7 (42%). In terms of differential diagnosis, some symptoms, physical findings, and laboratory tests showed meaningful differences between the case groups Conclusions: The following findings were determined as being important to alert physicians about the probability of a malignant disorder: location of lymphadenopathy, number of associated systemic symptoms, size of lymph node, abnormal laboratory findings, abnormal chest X-ray.

Acute Myocarditis Simulating Myocardial Infarction in a Child

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 250-253
Author(s):  
MARK H. HOYER ◽  
DONALD R. FISCHER
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Myocardial Ischemia ◽  
Acute Myocarditis ◽  
Acute Myocardial Ischemia ◽  
Detailed History ◽  
Pediatric Chest ◽  
Physical Findings

Pediatric chest pain usually occurs in benign conditions. However, this case portrays the dramatic electrocardiographic appearance of acute myocardial ischemia in a boy with biopsy-proven myocarditis who had only mild chest pain. This underscores the need for eliciting a detailed history when evaluating a patient with chest pain. If the pain cannot be clearly attributed to chest wall phenomena, or if there are historical or physical findings suggestive of an arrhythmia or angina, then further investigation with a chest radiograph and a 12-lead electrocardiogram is recommended. Myocarditis must be considered in the differential diagnosis of any child whose electrocardiogram is indistinguishable from an acute myocardial infarction.

The Cardiac Examination

2014 ◽  
pp. 795-805
Author(s):  
Joseph Loscalzo
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Medical Care ◽  
Cardiovascular System ◽  
Rank Order ◽  
High Technology ◽  
The Face ◽  
Examination Techniques ◽  
Physical Findings

In this era of high technology and expensive testing, there is nothing more important than a good history and physical examination in the process of medical care. A focused cardiac history allows the clinician to establish a differential diagnosis. The physical examination is utilized not only as an overall assessment of the cardiovascular system but more specifically to pursue those diagnoses in the historical differential that can be confirmed or refuted by the physical findings. Critical physical examination findings are rarely uncovered unless the clinician is specifically probing for given physical examination characteristics and knows what would be expected in the face of disease. Only by applying skilled history and physical examination techniques can the clinician determine the rank order of the differential diagnosis and order those tests most likely to answer the question with the least inconvenience, pain, and cost to the patient.

Tumor Diagnosis

1982 ◽  
Vol 40 ◽  
pp. 262-265
Author(s):  
Bruce Mackay
Keyword(s):  
Electron Microscopy ◽  
Transmission Electron Microscopy ◽  
Differential Diagnosis ◽  
Light Microscopy ◽  
Clinical Examination ◽  
Ultrastructural Study ◽  
Diagnostic Procedures ◽  
Specific Diagnosis ◽  
Transmission Electron ◽  
Microscopic Diagnosis

The broadest application of transmission electron microscopy (EM) in diagnostic medicine is the identification of tumors that cannot be classified by routine light microscopy. EM is useful in the evaluation of approximately 10% of human neoplasms, but the extent of its contribution varies considerably. It may provide a specific diagnosis that can not be reached by other means, but in contrast, the information obtained from ultrastructural study of some 10% of tumors does not significantly add to that available from light microscopy. Most cases fall somewhere between these two extremes: EM may correct a light microscopic diagnosis, or serve to narrow a differential diagnosis by excluding some of the possibilities considered by light microscopy. It is particularly important to correlate the EM findings with data from light microscopy, clinical examination, and other diagnostic procedures.

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