Seizures, epilepsy, and other episodic disorders in adults

2011 ◽  
Author(s):  
David Chadwick
Keyword(s):  
Differential Diagnosis ◽  
Grey Matter ◽  
Clinical Manifestations ◽  
Epileptic Seizures ◽  
Clinical Problem ◽  
Disturbance Of Consciousness ◽  
Transient Loss ◽  
Clonic Seizures ◽  
Definition Of ◽  
Common Clinical Problem

Epilepsy, or more correctly a seizure, is most easily defined in physiological terms, being ‘the name for occasional sudden, excessive, rapid, and local discharges of grey matter’ (Jackson 1873). It is more difficult to offer a comprehensive clinical definition of epileptic seizures and epilepsy because of the varied clinical manifestations produced by cerebral neuronal discharge. However, an epileptic seizure can be defined as an intermittent and stereotyped disturbance of consciousness, behaviour, emotion, motor function, or sensation that on clinical grounds is believed to result from cortical neuronal discharge. Epilepsy can then be defined as a condition in which seizures recur, usually spontaneously. The differential diagnosis of epilepsy is large because of the enormous range of symptoms that can occur during seizures. Inevitably, the differential diagnosis for tonic-clonic seizures is very different from that for simple partial seizures with autonomic symptoms. The most common clinical problem is the differential diagnosis from other causes of transient loss of consciousness associated with collapse, the commonest cause of which is syncope.

Can conversation analytic findings help with differential diagnosis in routine seizure clinic interactions?

2016 ◽  
Vol 12 (1) ◽  
pp. 13-24 ◽  
Author(s):  
Katie Ekberg ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Errors ◽  
Epileptic Seizures ◽  
Routine Clinical Setting ◽  
Choice Of Treatment ◽  
Transient Loss ◽  
Factual Content ◽  
Patient’S History ◽  
Linguistic Methods

There are many areas in medicine in which the diagnosis poses significant difficulties and depends essentially on the clinician’s ability to take and interpret the patient’s history. The differential diagnosis of transient loss of consciousness (TLOC) is one such example, in particular the distinction between epilepsy and ‘psychogenic’ non-epileptic seizures (NES) is often difficult. A correct diagnosis is crucial because it determines the choice of treatment. Diagnosis is typically reliant on patients’ (and witnesses’) descriptions; however, conventional methods of history-taking focusing on the factual content of these descriptions are associated with relatively high rates of diagnostic errors. The use of linguistic methods (particularly conversation analysis) in research settings has demonstrated that these approaches can provide hints likely to be useful in the differentiation of epileptic and non-epileptic seizures. This paper explores to what extent (and under which conditions) the findings of these previous studies could be transposed from a research into a routine clinical setting.

#3079 Investigating the feasibility of automating the differential diagnosis of transient loss of consciousness

2021 ◽  
Vol 92 (8) ◽  
pp. A7.1-A7
Author(s):  
Nathan Pevy ◽  
Heidi Christensen ◽  
Traci Walker ◽  
Markus Reuber
Keyword(s):  
Differential Diagnosis ◽  
Random Forest ◽  
Epileptic Seizures ◽  
The Other ◽  
Future Research ◽  
Loss Of Consciousness ◽  
Transient Loss Of Consciousness ◽  
Audio Recordings ◽  
Transient Loss ◽  
Nonepileptic Seizures

BackgroundThere are three common causes of Transient Loss of Consciousness (TLOC), syncope, epileptic and psychogenic nonepileptic seizures (PNES). Many individuals who have experienced TLOC initially receive an incorrect diagnosis and inappropriate treatment. Whereas syncope can be distinguished from the other two causes relatively easily with a small number of yes/no questions, the differentiation of the other two causes of TLOC is more challenging. Previous qualitative research based on the methodology of Conversation Analysis has demonstrated that epileptic and nonepileptic seizures are described differently when patients talk to clinicians about their TLOC experiences. One particularly prominent difference is that epileptic seizure descriptions are characterised by more formulation effort than accounts of nonepileptic seizures.AimThis research investigates whether features likely to reflect the level of formulation effort can be automatically elicited from audio recordings and transcripts of speech and used to differentiate between epileptic and nonepileptic seizures.MethodVerbatim transcripts of conversations between patients and neurologists were manually produced from video and audio recordings of interactions with 45 patients (21 epilepsy and24 PNES). The subsection of each transcript containing the patients account of their first seizure was manually extracted for the analysis. Seven automatically detectable features were designed as markers of formulation effort. These features were used to train a Random Forest machine learning classifier.ResultsThere were significantly more hesitations and repetitions in descriptions of first epileptic than nonepileptic seizures. Using a nested leave-one-out cross validation approach, 71% of seizures were correctly classified by the Random Forest classifier.ConclusionsThis pilot study provides proof of principle that linguistic features that have been automatically extracted from audio recordings and transcripts could be used to distinguish between epileptic seizures and PNES and thereby contribute to the differential diagnosis of TLOC. Future research should explore whether additional observations can be incorporated into a diagnostic stratification tool. Moreover, future research should explore the performance of these features when they have been extracted from transcripts produced by automatic speech recognition and when they are combined with additional information provided by patients and witnesses about seizure manifestations and medical history.

Helicobacter pylori infection and chronic, persistent cough: is there an association?

2007 ◽  
Vol 121 (10) ◽  
pp. 962-967 ◽  
Author(s):  
M Talaat ◽  
M S Gad ◽  
E A Magdy ◽  
S M Aggag ◽  
Y A Nour
Keyword(s):  
Helicobacter Pylori ◽  
Chronic Cough ◽  
Clinical Manifestations ◽  
Clinical Problem ◽  
Control Group ◽  
Potential Association ◽  
Persistent Cough ◽  
Stool Specimens ◽  
H Pylori ◽  
Common Clinical Problem

Introduction: Chronic, persistent cough is a common clinical problem, the cause of which sometimes remains unidentifiable.Aims: To study a potential association between Helicobacter pylori infection and chronic, persistent cough.Materials and methods: A clinical observational study with symptom analysis, including 162 patients whose main presenting complaint was chronic, persistent cough of unidentifiable cause (study group) and 42 patients with chronic, non-specific laryngopharyngeal manifestations not including chronic cough (control group).Results: Active H pylori infection was present in 86.4 per cent (140/162) of patients in the chronic cough group, as opposed to 45.2 per cent (19/42) of the control group, as confirmed by detection of H pylori antigen in stool specimens. This difference was statistically significant (p<0.001). There was a significant improvement of the chronic cough of 75.4 per cent (98/130) of patients after successful H pylori eradication using appropriate medical therapy (p<0.001).Conclusions: Helicobacter pylori infection may lead to laryngopharyngeal irritation, with several clinical manifestations including chronic, persistent cough. However, the exact mechanism of this requires further research.

scholarly journals Analisis Pengetahuan GERD Siswa Kelas 12 MAN IC Serpong 2018/2019

2019 ◽  
Author(s):  
Muhammad Dzaki Darmawan
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Clinical Problem ◽  
Therapeutic Modalities ◽  
Atypical Symptoms ◽  
The World ◽  
Definition Of ◽  
Common Clinical Problem

Gastroesophageal reflux disease (GERD) is a common clinical problem, affecting many people around the world. Patients are recognized by both classic and atypical symptoms. Diagnosis of the GERD based on many symptomps that have been known. Advances in diagnostic and therapeutic modalities have improved our ability to identify and manage disease complications. But many people, doesn’t know about the definition of GERD, the symptomps, diseases, and how to prevent and treat it well. Here, we discuss the knowledge of GERD.

scholarly journals Idiopatic Lobular Panniculitis as a common clinical problem

2019 ◽  
Vol 91 (5) ◽  
pp. 49-53
Author(s):  
O N Egorova ◽  
B S Belov ◽  
S I Glukhova ◽  
S G Radenska-Lopovok
Keyword(s):  
Median Duration ◽  
Disease Duration ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Clinical Problem ◽  
Immunohistochemical Studies ◽  
Common Clinical Problem ◽  
Lobular Panniculitis ◽  
Tuberculin Tests ◽  
Rheumatology Practice

Aim. To present clinical and laboratory characteristics of various forms of idiopatic lobular panniculitis (ILP) in modern rheumatology practice. Materials and methods. The study included 67 people (58 women and 9 men aged 20 to 76) with the referral diagnosis of "Erythema nodosa? Undifferentiated panniculitis?" in 76.2% of cases with a median disease duration of 78.91 [48; 540] months observed in the V.A. Nasonova Research Institute of Rheumatology. In 2007-2017 in addition to general clinical examination immunological, histological and immunohistochemical studies, computed tomography (CT) of the chest organs and tuberculin tests were performed. Results. Analysis of clinical manifestations allowed to distinguish four forms of ILP: nodular (n=30), plaque (n=10), infiltrative (n=15) and mesentric (n=12). The minimum median duration of the disease was detected in plaque form (8 [5; 11.5] months), while the median duration in case of infitrative form was 8.25 times longer (66 [36; 102] months, p38 °C and a small number (up to 5) of drain nodes; infiltrative - fever >38 °C, ulceration of nodes with the expiration of oily mass and scarring; mesenteric - pain in the abdominal area, the number of nodes less than 5 and the abdominal cavity CT results (inflammation of the adiopose tissue of the intestinal mesentery, omentum, adipose tissue of the pre - and retroperitoneal areas). Conclusion. The forms and activity of the disease determine the approaches to treatment in modern clinical practice. There is an obvious need to expand knowledge about this pathology among doctors and conduct further research in order to timely diagnose and search for the most effective methods of ILP treatment.

A glance on dystonias, how to recognize and handle them

2019 ◽  
pp. 22-29
Author(s):  
F. N. Mercan ◽  
E. Bayram ◽  
M. C. Akbostanci
Keyword(s):  
Differential Diagnosis ◽  
Movement Disorder ◽  
Age Of Onset ◽  
Clinical Manifestations ◽  
Body Part ◽  
Classification Model ◽  
Treatment Choices ◽  
Muscle Groups

Dystonia refers to an involuntary, repetitive, sustained, painful and twisting movements of the affected body part. This movement disorder was first described in 1911 by Hermain Oppenheim, and many studies have been conducted to understand the mechanism, the diagnosis and the treatment of dystonia ever since. However, there are still many unexplained aspects of this phenomenon. Dystonia is diagnosed by clinical manifestations, and various classifications are recommended for the diagnosis and the treatment. Anatomic classification, which is based on the muscle groups involved, is the most helpful classification model to plan the course of the treatment. Dystonias can also be classified based on the age of onset and the cause. These dystonic syndromes can be present without an identified etiology or they can be clinical manifestations of a neurodegenerative or neurometabolic disease. In this review we summarized the differential diagnosis, definition, classifications, possible mechanisms and treatment choices of dystonia.

scholarly journals The Differential Diagnosis of Sterile Pyuria in Pediatric Patients: A Review

2021 ◽  
Vol 8 ◽  
pp. 2333794X2199371
Author(s):  
Donald W. Bendig
Keyword(s):  
Differential Diagnosis ◽  
Pediatric Patients ◽  
Systemic Disease ◽  
Common Finding ◽  
Extensive Literature ◽  
Sexually Transmitted ◽  
Persistent Symptoms ◽  
Sterile Pyuria ◽  
Extensive Literature Search ◽  
Definition Of

Sterile pyuria is a common finding in pediatric patients. Literature describing the diagnoses as well as clinical characteristics of children with sterile pyuria is lacking. This review was performed to establish an evidence-based approach to the differential diagnosis by way of an extensive literature search. The definition of pyuria is inconsistent. The various causes of pediatric sterile pyuria identified were classified as either Infectious or Non-Infectious. Sub-categories of Infectious causes include: Viral Infection, Bacterial Infection, Other Infections (tuberculosis, fungal, parasitic), Sexually Transmitted Infections, Recent Antibiotic Therapy. Non-Infectious causes include: Systemic Disease, Renal Disease, Drug Related, Inflammation adjacent to Genitourinary Tract. Clinicians that encounter pediatric patients with sterile pyuria and persistent symptoms should consider the substantial differential diagnosis described in this study.

Chronic pain following elective inguinal hernia repair—is it a common clinical problem?

2007 ◽  
Vol 32 (Suppl. 1) ◽  
pp. 174
Author(s):  
Z. M. Kirkor ◽  
T. N. Evans ◽  
H. Mathew ◽  
C. Swart ◽  
C. Morris ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Inguinal Hernia ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Clinical Problem ◽  
Common Clinical Problem

scholarly journals The risk of shoulder pain after laparoscopic surgery for infertility is higher in thin patients

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Xin You Li ◽  
Ming Tian ◽  
Ai Zhi Li ◽  
Chun Lei Han ◽  
Ke Zhong Li
Keyword(s):  
Laparoscopic Surgery ◽  
Shoulder Pain ◽  
Prospective Observational Study ◽  
Conditional Logistic Regression ◽  
Specific Treatment ◽  
Clinical Problem ◽  
Pain Visual Analogue Scale ◽  
Risk Patients ◽  
Treatment Plans ◽  
Common Clinical Problem

AbstractPostlaparoscopic shoulder pain (PLSP) is a common clinical problem that needs to be addressed by medical professionals who are currently perform laparoscopic surgeries. The purpose of this study was to determine the perioperative clinical factors and demographic characteristics associated with PLSP. A prospective observational study was performed with 442 inpatients undergoing laparoscopic surgery for infertility. The pain visual analogue scale was used as the measuring instrument. To identify the predictors of PLSP, we performed multivariate conditional logistic regression. PLSP was correlated with body mass index (BMI, odds ratio = 0.815). The incidence of shoulder pain and more severe shoulder pain in patients with a lower BMI was significantly higher than it was in patients with a higher BMI, and BMI was significantly negatively correlated with PLSP. Most of the patients (95%) began to experience shoulder pain on the first postoperative day, and it rarely occurred on the day of surgery. Patients with lower BMI presented a higher risk of reporting shoulder pain on the first postoperative day. We should identify high-risk patients in advance and make specific treatment plans according to the characteristics of their symptoms.

scholarly journals Pulvinar sign in a case of anti-HU paraneoplastic encephalitis

2016 ◽  
Vol 29 (6) ◽  
pp. 436-439 ◽  
Author(s):  
Pierre-Luc Gamache ◽  
Maude-Marie Gagnon ◽  
Martin Savard ◽  
François Émond
Keyword(s):  
Magnetic Resonance Imaging ◽  
Differential Diagnosis ◽  
Magnetic Resonance ◽  
Clinical Manifestations ◽  
Resonance Imaging ◽  
Paraneoplastic Encephalitis ◽  
Jakob Disease ◽  
Magnetic Resonance Imaging Mri ◽  
Work Up

This article reports the case of a 68-year-old patient with anti-HU antibodies paraneoplastic encephalitis. The clinical manifestations were atypical and the paraclinical work-up, notably the magnetic resonance imaging (MRI) showing bilateral posterior thalamic hyperintensities (pulvinar sign), misleadingly pointed towards a variant Creutzfeld–Jakob disease. After presenting the case, the differential diagnosis of the pulvinar sign is discussed along with other important diagnostic considerations.

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