The differential diagnosis of spastic diplegia

2014 ◽  
Vol 100 (5) ◽  
pp. 500-504 ◽  
Author(s):  
Richard Huntsman ◽  
Edmond Lemire ◽  
Jonathon Norton ◽  
Anne Dzus ◽  
Patricia Blakley ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Cerebral Palsy ◽  
Correct Diagnosis ◽  
Diagnostic Algorithm ◽  
Spastic Diplegia ◽  
Family Counselling

Spastic diplegia is the most common form of cerebral palsy worldwide. Many disorders mimic spastic diplegia, which can result in misdiagnosis for the child with resultant negative treatment and family counselling implications. In this paper, the authors provide a brief review of spastic diplegia and the various disorders in the differential diagnosis. We also provide a diagnostic algorithm to assist physicians in making the correct diagnosis.

Bronchocele (bronchial retention cyst): from structure to diagnosis

MedAlliance ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 63-73
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Foreign Body ◽  
Lung Metastases ◽  
Correct Diagnosis ◽  
Diagnostic Algorithm ◽  
Bronchial Tree ◽  
Retention Cyst ◽  
Examination Methods ◽  
Atypical Manifestation

SummaryIntroduction. Bronchocele is a relatively frequent inci-dental finding on computed tomography and is a dilated bronchus filled with mucous content due to continued se-cretion of the mucous membrane and proximal airway ob-struction, which often manifests itself as tubular branched structures associated with the bronchial tree («Finger in glove» sign). Purpose: to present “from simple to complex” diagnostic algorithm for detecting changes in the type of bronchocele on computed tomography. Results. The dif-ferential diagnosis of the causes of bronchocele is wide and includes both congenital and acquired pathologies, which can be divided into obstructive and non-obstructive. Also, etiology-wise, they can be divided into the following groups: congenital infectious pathology, and obstruction of the bronchus by masses or foreign body. Computed tomography is the preferred method for diagnosing bron-chocele; in some cases, CT is performed in combination with contrast enhancement for differential diagnosis with arteriovenous malformation or atypical manifestation of lung metastases. In case of a locally located bronchocele, obstructive genesis by masses or foreign body should always be excluded, which requires the use of broncho-scopic examination methods. The most difficult option for differential diagnosis is bronchocele caused by infectious agents, due to the non-specificity of the radiation pattern. To make a correct diagnosis, it is necessary to verify and identify the pathogen. Conclusion. The paper presents a diagnostic algorithm that allows to optimally diagnoseis the “bronchocele” type changes.

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.

scholarly journals Standardized Outcomes Measures in Physical Therapy Practice for Treatment and Rehabilitation of Cerebral PALSY: A Systematic Review

2021 ◽  
Vol 11 (7) ◽  
pp. 604
Author(s):  
Maria Dolores Apolo-Arenas ◽  
Aline Ferreira de Araújo Jerônimo ◽  
Alejandro Caña-Pino ◽  
Orlando Fernandes ◽  
Joana Alegrete ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Physical Therapy ◽  
Gait Training ◽  
Physical Therapy Modalities ◽  
Spastic Diplegia ◽  
Evaluation Procedures ◽  
Outcomes Measures ◽  
Prisma Statement ◽  
Spastic Hemiplegia

Cerebral palsy (CP) treatment includes physical therapy and various complementary therapies to the standard clinical treatment. However, there are not many reviews that focus on the methods used and evaluation procedures. This study aims to analyze which tools are most suitable for the evaluation and methodology of patients with CP treated with physical therapy. Following the PRISMA statement, through a PICOS strategy, PubMed/MEDLINE, Web of Science (WOS), Scopus, Science Direct, and Scielo were searched with the following terms: cerebral palsy AND (physical therapy modalities OR therapeutics) AND outcome assessment. The methodological quality of the RCTs was assessed with the Evidence Project risk of bias tool. Thirty-seven RCTs and six RCT protocols, comprising 1359 participants with different types of CP: spastic hemiplegia/paresis, spastic diplegia/paresis, and spastic CP, met the inclusion criteria, uncovering 21 variables measured through 77 different instruments and several interventions. The therapies most widely used in CP are gaming or technology-assisted therapies, aerobic training, hippotherapy, music therapy, gait training, and aquatic exercises. This study provides an overview of what the authors used in the neurorehabilitation field through procedure evaluation and checking the technological advance that began to be used.

scholarly journals Effects of Dynamic Elastomeric Fabric Orthoses on Children with Cerebral Palsy

2009 ◽  
Vol 33 (4) ◽  
pp. 339-347 ◽  
Author(s):  
Martin John Matthews ◽  
Martin Watson ◽  
Barbara Richardson
Keyword(s):  
Cerebral Palsy ◽  
Single Case ◽  
Phase 1 ◽  
Functional Mobility ◽  
Gait Velocity ◽  
Controlled Study ◽  
Patient Specific ◽  
Spastic Diplegia ◽  
Cost Index ◽  
Beneficial Effects

This phase 1 exploratory study aimed to establish proof of concept of the effects of dynamic elastomeric fabric orthoses (DEFOs) on the gait of children with spastic diplegic cerebral palsy. Replicated single case experiments employing an ABA methodology were carried out on eight subjects (median age 5.5 years, range 3–13 years; 4 girls/boys) utilizing quantitative/qualitative data collection. Outcome measures were: Ten metre walking test (10MWT); physiological cost index (PCI); visual analogue scale (VAS) scoring of perceived gait changes; functional mobility changes using Patient Specific Functional Scale (PSFS); subject/carer perceptions recorded in daily diaries. Results identified following analysis of quantitative data indicated a treatment effect from the orthoses which could be corroborated by participant subjective impressions and comments. Statistically significant ( p < 0.05) intervention-related improvements in gait velocity and gait consistency were identified respectively in 5/8 and 4/8 subjects. Power calculations support the feasibility of a larger controlled study to further investigate this orthotic intervention. This study indicates that DEFO leggings can confer beneficial effects on the gait of some children with spastic diplegia resulting from CP. These findings have implications for orthotic intervention with this subject group.

Perianal Lymphangioma Circumscriptum Mistaken for Genital Warts

PEDIATRICS ◽  
1996 ◽  
Vol 98 (3) ◽  
pp. 461-463
Author(s):  
Gary L. Darmstadt
Keyword(s):  
Sexual Abuse ◽  
Differential Diagnosis ◽  
Case Report ◽  
Correct Diagnosis ◽  
Genital Warts ◽  
Diagnosis And Treatment ◽  
Perianal Region ◽  
Anogenital Region ◽  
Left Buttock ◽  
Lymphangioma Circumscriptum

Genital warts are common relative to other verrucous lesions of the anogenital region. Consideration of the differential diagnosis of verrucous anogenital lesions is necessary, however, to make a correct diagnosis consistently and to avoid futile, painful, and possibly traumatic attempts at treatment. In this report, I describe a child with a history suspicious for sexual abuse who was treated with inappropriate measures because of misdiagnosis of perianal lymphangioma circumscriptum as genital warts. The pathogenesis, differential diagnosis, and treatment of lymphangioma is presented. CASE REPORT A 5-year-old Hispanic boy was referred by his pediatrician to the Dermatology Service with an eruption of red papules on the left buttock and perianal region.

BRAIN TUMORS IN INFANCY

PEDIATRICS ◽  
1948 ◽  
Vol 1 (3) ◽  
pp. 346-363
Author(s):  
I. WALLACE LEIBNER
Keyword(s):  
Nervous System ◽  
Differential Diagnosis ◽  
Brain Tumors ◽  
Correct Diagnosis ◽  
Full Recovery ◽  
The Other ◽  
Congenital Hydrocephalus ◽  
First Case ◽  
Clinical Patterns

Seven cases of brain tumors occurring in infants are presented. Six occurred in males and one was in a female. Three of them arose in the cerebellum while the other four were supratentorial. The tumors included two medulloblastomas, one [See Table II in Source Pdf] spongioblastoma polare, one ependymoma, one astrocytoma and one hemangioblastoma. The seventh case probably was also one of medulloblastoma. One of the proven medulloblastomas was supratentorial, which is unusual so faras location is concerned. The hemangioblastoma arose in the cerebrum. The location of this tumor is also a rare one and to my knowledge, it is the first case of its type reported in an infant in whom full recovery occurred following removal of the tumor. The diagnosis was unsuspected in four cases. Three of these infants were believed to be suffering from congenital hydrocephalus while the fourth was thought to be afflicted with encephalitis. The ways in which the correct diagnosis might have been made are discussed. Since bizarre clinical patterns are sometimes produced by brain tumors in infants and the diagnosis frequently overlooked, the possibility should be kept in mind by the pediatrician in considering the differential diagnosis of conditions producing signs referable to the nervous system.

Discontinuation of Antiepileptic Drug Treatment After Two Seizure-free Years in Children With Cerebral Palsy

PEDIATRICS ◽  
1996 ◽  
Vol 97 (2) ◽  
pp. 192-197
Author(s):  
Mauricio R. Delgado ◽  
Anthony R. Riela ◽  
Janith Mills ◽  
Alan Pitt ◽  
Richard Browne
Keyword(s):  
Cerebral Palsy ◽  
Mental Retardation ◽  
Antiepileptic Drug ◽  
Spastic Diplegia ◽  
Multiple Factors ◽  
Spastic Hemiparesis ◽  
Children With Cerebral Palsy ◽  
Epileptic Children ◽  
Seizure Relapse ◽  
Antiepileptic Drug Treatment

Objective. The risk of seizure relapse after antiepileptic drug (AED) discontinuation in children has been reported to vary between 6% and 40%. It has been suggested that neurologic deficit and mental retardation are poor prognostic factors for seizure relapse after AED discontinuation. Because epileptic children with cerebral palsy (CP) have neurologic deficits, and many have mental retardation, it is important to know their risk for seizure relapse. Methods. AED treatment was discontinued in 65 children with CP and histories of epilepsy after 2 seizure-free years. All of the patients were followed until they had seizure relapses or for at least 2 years without seizures after AEDs were stopped. Multiple factors were analyzed for possible association with seizure relapse. Results. Twenty-seven patients (41.5%) had seizure relapses. Patients with spastic hemiparesis had the highest relapse rate (61.5%), and those with spastic diplegia had the lowest rate (14.3%). No other factor correlated significantly with the risk of seizure relapse. Conclusions. Discontinuation of AEDs in children with CP can, and should, be practiced when possible after patients have been seizure-free for at least 2 years. AED discontinuation in patients with spastic hemiparesis is significantly more likely to lead to seizure relapse than in patients with other CP types, but no other factor is yet known to increase the chance of relapse.

MEDICAL FILMS

PEDIATRICS ◽  
1962 ◽  
Vol 30 (6) ◽  
pp. 1018-1018
Keyword(s):  
Cystic Fibrosis ◽  
New York ◽  
New York City ◽  
Differential Diagnosis ◽  
Correct Diagnosis ◽  
Diagnostic Tools ◽  
Single Test ◽  
Presenting Symptoms ◽  
The Many ◽  
Therapy And Diagnosis

Cystic Fibrosis—NCFRF. 16 mm., color, sound, showing time 32 minutes. Produced in 1961 by Samuel L. Schulman for the National Cystic Fibrosis Research Foundation, medical supervision by Giulio J. Barbero, M.D. Philadelphia. Procurable on purchase from National Cystic Fibrosis Research Foundation, 521 Fifth Avenue, New York City 17. Procurable on loan from American Medical Association, Motion Picture Library, 535 N. Dearborn Street, Chicago 10. This film has been prepared to aid physicians in making a correct diagnosis and to instruct them in the techniques currently being used to prolong life in cases of cystic fibrosis. Following the introductoy remarks there is a good discussion of the presenting symptoms, the differential diagnosis, the multiple system involvement, hereditary aspects, therapy, and prognosis. The film brings out well the panexocrine involvement, the clinical variability, and the fact that the disease is not an all or none phenomenon but rather a disease of all grades of severity and is a disease in which no single test is applicable to the exclusion of others. The diagrams and patient demonstrations are good. Perhaps too much review of older methods of therapy and diagnosis is given, but this serves as a background for the newer recommended procedures. More emphasis could have been given to the tremendous burden, both financial and emotional, this disease is on parents. This is an excellent instructive film and it emphasizes the many problems of cystic fibrosis as related to the diagnostic tools available and to forms of therapy. The photography and sound are satisfactory. It is recommended for pediatricians, general practitioners, house staff, and medical students.

DIAGNOSIS OF OVARIAN CANCER AND ACUTE ENDOMETRITIS BY NETWORK MODELING OF CHANGES IN BLOOD FLOW IN THE PELVIC ARTERIES

2021 ◽  
pp. 88-93
Author(s):  
Виталий Вячеславович Аксёнов ◽  
Николай Михайлович Агарков ◽  
Александра Игоревна Сурнина
Keyword(s):  
Ovarian Cancer ◽  
Blood Flow ◽  
Differential Diagnosis ◽  
Network Modeling ◽  
Correct Diagnosis ◽  
Arterial Blood Flow ◽  
Diagnostic Significance ◽  
The Past ◽  
Arterial Blood ◽  
High Level

Заболеваемость раком яичников в России в последнее время остается на высоком уровне. В мире более ста тысяч женщин умирают вследствие протекания данного заболевания. За последнее десятилетие заболеваемость острым эндометритом также неуклонно возрастает. Острый эндометрит обладает полиморфизмом симптомов, лабораторных и ультразвуковых изменений и вследствие этого тяжело поддается диагностике и дифференциальной диагностике. В условиях стационара обследованы 100 пациенток с раком яичников II-III стадии и 90 пациенток с диагнозом острого эндометрита. Им выполнялось ультразвуковое исследование. Полученные результаты подвергались обработке и математико-статистическому анализу, включающему расчёт показателей дезинтеграции, сетевое моделирование, математическое ранжирование. Изучение ультразвуковых изменений кровотока в маточных и яичниковых сосудах и венах у 100 заболевших раком яичников и 90 заболевших острым эндометритом дал возможность выделить ведущие дифференциально-диагностические аспекты. Характеристики дезинтеграции, в одном ряду со средними значениями локального кровотока, объективизируют дифференциацию рака яичников и острого эндометрита. В согласовании с дифференциально-диагностической значимостью ультразвуковых характеристик артериального кровотока в маточных и яичниковых сосудах построена сетевая модель дифференциальной диагностики рака яичников и острого эндометрита по более приоритетным переменам, собственно, что разрешает уменьшить размер и время обследования пациента и постановки верного диагноза The incidence of ovarian cancer in Russia has recently remained at a high level. In the world, more than a hundred thousand women die as a result of the course of this disease. The incidence of acute endometritis has also been steadily increasing over the past decade. Acute endometritis has a polymorphism of symptoms, laboratory and ultrasound changes and, as a result, is difficult to diagnose and differential diagnosis. 100 patients with stage II-III ovarian cancer and 90 patients with acute endometritis were examined in the hospital. They performed an ultrasound examination. The obtained results were processed and subjected to mathematical and statistical analysis, including the calculation of disintegration indicators, network modeling, and mathematical ranking. The study of ultrasound changes in blood flow in the uterine and ovarian vessels and veins in 100 patients with ovarian cancer and 90 patients with acute endometritis made it possible to identify the leading differential diagnostic aspects. The characteristics of disintegration, along with the average values of local blood flow, objectify the differentiation of ovarian cancer and acute endometritis. In accordance with the differential diagnostic significance of the ultrasound characteristics of arterial blood flow in the uterine and ovarian vessels, a network model for the differential diagnosis of ovarian cancer and acute endometritis is constructed according to higher priority changes, which actually allows reducing the size and time of the patient's examination and making the correct diagnosis

Rectovaginal extragastrointestinal stromal tumour (EGIST): an additional entity to be considered in the differential diagnosis of tumours of the rectovaginal septum

2021 ◽  
Vol 14 (3) ◽  
pp. e237669
Author(s):  
Susan Addley ◽  
Moiad Alazzam ◽  
Catherine Johnson ◽  
Hooman Soleymani majd
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
High Risk ◽  
Kinase Inhibitor ◽  
Correct Diagnosis ◽  
Rectovaginal Septum ◽  
Gastrointestinal Stromal Tumours ◽  
Diagnostic Challenge ◽  
High Quality ◽  
Primary Surgery

Gastrointestinal stromal tumours (GISTs) are rare - and rectovaginal extragastrointestinal stromal tumours (RV-EGISTs) even rarer. We share a case of RV-EGIST, complemented by high-quality radiological and surgical images. A review of current literature pertaining to RV-EGIST is also included. Our case report highlights the diagnostic challenge presented by extragastrointestinal stromal tumours. Differentiated from overlapping pathologies only by targeted application of immunohistopathology and cytogenetics, the inclusion of RV-EGIST in the differential diagnosis of a rectovaginal tumour is essential to making this correct diagnosis. Primary surgery is the treatment of choice for RV-EGIST if complete cytoreduction can be achieved, combined with adjuvant tyrosine kinase inhibitor (TKI) therapy for those with high-risk features to further reduce rates of future recurrence.

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