Diagnostic and Therapeutic Management of a First Unprovoked Seizure in Children and Adolescents With a Focus on the Revised Diagnostic Criteria for Epilepsy

2017 ◽  
Vol 32 (8) ◽  
pp. 774-788 ◽  
Author(s):  
Arnold J. Sansevere ◽  
Jennifer Avalone ◽  
Lauren Doyle Strauss ◽  
Archana A. Patel ◽  
Anna Pinto ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Children And Adolescents ◽  
Diagnostic Criteria ◽  
Laboratory Tests ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Therapeutic Management ◽  
Unprovoked Seizure ◽  
Definition Of

By definition, unprovoked seizures are not precipitated by an identifiable factor, such as fever or trauma. A thorough history and physical examination are essential to caring for pediatric patients with a potential first unprovoked seizure. Differential diagnosis, EEG, neuroimaging, laboratory tests, and initiation of treatment will be reviewed. Treatment is typically initiated after 2 unprovoked seizures, or after 1 seizure in select patients with distinct epilepsy syndromes. Recent expansion of the definition of epilepsy by the ILAE allows for the diagnosis of epilepsy to be made after the first seizure if the clinical presentation and supporting diagnostic studies suggest a greater than 60% chance of a second seizure. This review summarizes the current literature on the diagnostic and therapeutic management of first unprovoked seizure in children and adolescents while taking into consideration the revised diagnostic criteria of epilepsy.

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.

scholarly journals Differential Diagnosis of Pediatric Multiple Sclerosis

Children ◽  
2019 ◽  
Vol 6 (6) ◽  
pp. 75 ◽  
Author(s):  
Maria Milagros Galardi ◽  
Cristina Gaudioso ◽  
Saumel Ahmadi ◽  
Emily Evans ◽  
Laura Gilbert ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Differential Diagnosis ◽  
Diagnostic Criteria ◽  
Clinical Presentation ◽  
Correct Diagnosis ◽  
Acute Disseminated Encephalomyelitis ◽  
Test Results ◽  
Pediatric Multiple Sclerosis ◽  
Ancillary Test ◽  
Spectrum Disorders

The differential diagnosis of pediatric multiple sclerosis (MS) can be broad and pose diagnostic challenges, particularly at initial presentation. Among demyelinating entities, neuromyelitis optica spectrum disorders (NMOSD), myelin oligodendrocyte glycoprotein antibodies (MOG-ab) associated disorders, and acute disseminated encephalomyelitis (ADEM) are now well-known as unique disease processes and yet continue to overlap with MS in regards to clinical presentation and imaging. In non-inflammatory entities, such as metabolic disorders and leukodystrophies, an erroneous diagnosis of MS can be made even while applying appropriate diagnostic criteria. Knowing the epidemiology, typical clinical presentation, diagnostic criteria, and ancillary test results in each disease, can aid in making the correct diagnosis by contrasting these features with those of pediatric MS. Determining the correct diagnosis early, allows for efficient and effective treatment as well as appropriate prognostication.

Eosinophilic Pustular Folliculitis

PEDIATRICS ◽  
1992 ◽  
Vol 89 (6) ◽  
pp. 1095-1098
Author(s):  
GARY L. DARMSTADT ◽  
WALTER W. TUNNESSEN ◽  
RONALD J. SWEREN
Keyword(s):  
Differential Diagnosis ◽  
Effective Treatment ◽  
Clinical Experience ◽  
Pediatric Patients ◽  
Clinical Presentation ◽  
Clinical Entity ◽  
Treatment Modalities ◽  
First Report ◽  
Eosinophilic Infiltrate ◽  
Insight Into

Eosinophilic pustular folliculitis is a cutaneous disorder that consists of recurrent crops of pruritic, sterile, papulopustules in a follicular distribution. In pediatric patients, EPF presents primarily in the scalp and is confused with several other more common dermatoses in children. The diagnosis of EPF rests on its inclusion in the differential diagnosis of papulo-pustular disorders, the recognition of the clinical presentation, and the presence of an eosinophilic infiltrate on biopsy. Treatment with midpotency topical coticosteroids has thus far met with modest success. This is the first report on EPF in the pediatric literature. As pediatricians become more aware of EPF as a distinct clinical entity and as our clinical experience and insight into the pathogenesis of EPF grows, perhaps more effective treatment modalities will be devised.

Fever of Unknown Origin

2012 ◽  
pp. 237-243
Author(s):  
Mary J. Kasten
Keyword(s):  
Physical Examination ◽  
Laboratory Tests ◽  
Fever Of Unknown Origin ◽  
Unknown Origin ◽  
Definitive Diagnosis ◽  
Radiographic Testing ◽  
Common Causes ◽  
The Common ◽  
Definition Of ◽  
Comprehensive History

Classic definition of fever of unknown origin (FUO) is a fever for more than 3 weeks, a temperature of 38.3 C or higher on several occasions, and no definitive diagnosis after 1 week of hospital evaluation. Recent series have used other criteria instead of 1 week of hospital evaluation: 1 week of intensive outpatient evaluation, 3 outpatient visits, or a battery of laboratory tests. A comprehensive history should be obtained and a physical examination and basic laboratory and radiographic testing should be performed before stating that a patient has FUO. There is no clear consensus in the literature for defining the minimal diagnostic evaluation. The common causes of FUO are infection, cancer, rheumatologic or autoimmune disorders, and miscellaneous hematologic conditions. Treatment is empirical if a cause is not found.

scholarly journals Scleroderma with Acro-Osteolysis and Papular Mucinosis Resembling Multicentric Reticulohistiocytosis

2020 ◽  
Author(s):  
João Dantas ◽  
Isabela S de Oliveira ◽  
Emanuela P Fonseca ◽  
Mittermayer Barreto Santiago
Keyword(s):  
Differential Diagnosis ◽  
Systemic Sclerosis ◽  
Bone Resorption ◽  
Physical Examination ◽  
Skin Biopsy ◽  
Laboratory Tests ◽  
Skin Lesions ◽  
Imaging Studies ◽  
Plain Radiographs ◽  
Multicentric Reticulohistiocytosis

Objectives: We describe a case of systemic sclerosis (SS) with acro-osteolysis associated with cutaneous mucinosis, usually characterized by mucin deposition in the skin. The main differential diagnosis was multicentric reticulohistiocytosis due to the presentation of papulonodular skin lesions. Materials and methods: A physical examination, imaging studies and laboratory tests were performed. Results: Distal bone resorption was evident on plain radiographs, and skin biopsy confirmed mucinosis. The SS diagnosis was based on the clinical features, high levels of antinucleolar antibodies and typical nailfold capillaroscopy findings. Conclusion: To the best of our knowledge, this is the first description of cutaneous mucinosis accompanying SS with acro-osteolysis.

Complex regional pain syndrome: observations on diagnosis, treatment and definition of a new subgroup

2012 ◽  
Vol 38 (6) ◽  
pp. 599-606 ◽  
Author(s):  
A. Żyluk ◽  
P. Puchalski
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Diagnostic Criteria ◽  
Clinical Presentation ◽  
Early Stage ◽  
Pain Syndrome ◽  
Clinical Use ◽  
Practical Guideline ◽  
Definition Of ◽  
Variable Clinical Presentation

Several definitions and sets of diagnostic criteria of complex regional pain syndrome have been proposed, but to date none has been accepted completely. This article presents a specific subtype of the disease, called ‘chronic, refractory complex regional pain syndrome’ which is extremely severe, disabling and resistant to treatment. It also emphasizes difficulties with diagnosing complex regional pain syndrome because of its variable clinical presentation and diagnostic criteria being insufficiently precise. The necessity to distinguish between criteria for clinical use and for scientific purposes is suggested with a proposal of practical guideline for diagnosing acute complex regional pain syndrome. A review of treatments for complex regional pain syndrome is presented, with opinion on their effectiveness: good in an early stage, less well in chronic and generally poor in the chronic, refractory subtype.

scholarly journals A case of seminoma presented with clinical manifestations of testicular torsion

2017 ◽  
Vol 89 (3) ◽  
pp. 236
Author(s):  
Aytac Sahin ◽  
Caglar Yildirim ◽  
Serkan Akan ◽  
Ozgur Haki Yuksel ◽  
Ahmet Urkmez
Keyword(s):  
Differential Diagnosis ◽  
Physical Examination ◽  
Clinical Picture ◽  
Laboratory Tests ◽  
Testicular Torsion ◽  
Clinical Manifestations ◽  
Testicular Tumor ◽  
Imaging Modalities ◽  
Acute Scrotum ◽  
Testicular Tumors

Testicular tumors rarely manifest themselves with clinical picture of testicular torsion. In this presentation of ours, we reported a 30-year-old patient whose post-orchiectomy histopathology report revealed the presence of seminoma. The patient consulted us with acute scrotum whose physical examination and Doppler ultrasonographic findings showed testicular torsion. Though rarely seen patients, in cases who consulted with acute scrotum, the possibility of testicular tumor should not be discarded. For the establishment of differential diagnosis detailed anamnesis and physical examination findings should be supported with laboratory tests and imaging modalities.

Definition of Apathy and Differential Diagnosis

2021 ◽  
pp. 1-18
Author(s):  
Philippe Robert ◽  
Valeria Manera
Keyword(s):  
Differential Diagnosis ◽  
Clinical Practice ◽  
Major Depression ◽  
Diagnostic Criteria ◽  
Brain Disorders ◽  
Theoretical Level ◽  
Neuropsychiatric Diseases ◽  
Definition Of

Motivation, initiation, interest, goal-directed behaviour, reward, and incentive are just some of the words associated with the concept of apathy in brain disorders. This vocabulary is even richer if we encompass different neuropsychiatric diseases, such as schizophrenia and major depression. This is a paradox for this concept, which is so difficult to capture and to define at the theoretical level, and at the same time easy to understand and observe in clinical practice. This chapter aims to summarize the different apathy definitions, present the diagnostic criteria for apathy in brain disorders, and discuss differential diagnosis and overlap with other conditions, such as anhedonia, fatigue, and depression.

Hypersexuality in Inpatient Children and Adolescents: Recognition, Differential Diagnosis, and Evaluation

CNS Spectrums ◽  
2007 ◽  
Vol 12 (11) ◽  
pp. 821-827 ◽  
Author(s):  
Fayez El-Gabalawi ◽  
Robert Arnold Johnson
Keyword(s):  
Differential Diagnosis ◽  
Sexual Behavior ◽  
Polycystic Ovary Syndrome ◽  
Children And Adolescents ◽  
Sexual Behaviors ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Common Cause ◽  
Inappropriate Sexual Behavior ◽  
Definition Of

ABSTRACTWe describe a 17-year-old girl with hypersexuality resulting from virilization, the latter a consequence of polycystic ovary syndrome, and we review the literature pertinent to hypersexuality in children and adults. Inappropriate sexual behavior (a common cause of disruption among children who are hospitalized for psychiatric disorders) may be caused either by hypersexuality or by simply ill-regulated behavior: a definition of hypersexuality is proposed that can be applied at the bedside (namely, sexual behaviors or fantasies that have abruptly increased in frequency by comparison with a previous baseline, are of sufficient excessiveness to disrupt expected or usual social, academic, or occupational functioning, or constitute a source of distress), so that this distinction can be made promptly, and we present a differential diagnosis for hypersexuality to direct its evaluation. Virilization does not seem to be a common cause of hypersexuality in children and adolescents, but it should not be overlooked when it does exist.The differential diagnosis of hypersexuality in adults, which we present for comparison, is much larger than it is in children.

scholarly journals Clinical presentation, differential diagnosis and management of bipolar disorder in children and adolescents: a review

2021 ◽  
Vol 8 (11) ◽  
pp. 1769
Author(s):  
Jeplin Bez
Keyword(s):  
Bipolar Disorder ◽  
Mental Illness ◽  
Differential Diagnosis ◽  
Children And Adolescents ◽  
20Th Century ◽  
Clinical Presentation ◽  
Adult Population ◽  
Age Group ◽  
Children And Adolescent ◽  
Management Approaches

Bipolar disorder is a mental illness that causes serious disabilities in both social and work function. The occurrence of this disorder in children and adolescent age group has gained the attention of research workers since the 20th century. The varied clinical presentation of this disorder in comparison to the adult population, as well as the management approaches have been a matter of debate for ages. The aim of the study was to put forward the diagnostic and treatment approaches of bipolar disorder in children and adolescent.

Sign in / Sign up

Export Citation Format

Share Document