Paroxysmal Choreoathetosis: Report of Five Cases and Review of the Literature

Paroxysmal choreoathetosis is a rare, involuntary movement disorder. Attacks occur spontaneously or may be induced by movement, startle, or anxiety. The movements are tonic, dystonic, or choreoathetotic. Sporadic and, more commonly, familial cases have been reported. Onset occurs most often during childhood, and the course is nonprogressive. Response to anticonvulsant therapy is usually excellent. Five cases of the sporadic form of paroxysmal choreoathetosis are reported. Three of the five patients had attacks after initiation of movements such as rising from a chair. Results of physical examination were normal in four patients. One child had mild hemiatrophy and unilateral hyper-reflexia. Results of laboratory studies, including determinations of serum calcium and ceruloplasmin levels, EEGs, and CAT scans of the head, were normal. The attacks ceased in all patients after treatment with either phenytoin or carbamazepine.

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Faculty Opinions recommendation of Reliability of physical examination for diagnosis of myofascial trigger points: a systematic review of the literature.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.3137956.2822055 ◽

2010 ◽

Author(s):

Wilfrid Jänig

Keyword(s):

Systematic Review ◽

Physical Examination ◽

Trigger Points ◽

Review Of The Literature ◽

Myofascial Trigger Points

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Nasal Epithelial Myoepithelial Carcinoma: An Unusual Cause of Epiphora, a Case Report and Review of the Literature

Allergy & Rhinology ◽

10.2500/ar.2015.6.0127 ◽

2015 ◽

Vol 6 (2) ◽

pp. ar.2015.6.0127 ◽

Cited By ~ 7

Author(s):

Juliette O. Flam ◽

Christopher D. Brook ◽

Rachel Sobel ◽

John C. Lee ◽

Michael P. Platt

Keyword(s):

Case Report ◽

Physical Examination ◽

Nasal Cavity ◽

Surgical Excision ◽

Myoepithelial Carcinoma ◽

Review Of The Literature ◽

Nasal Symptoms ◽

First Case ◽

Nasal Tumor ◽

Epithelial Myoepithelial Carcinoma

Introduction Epithelial myoepithelial carcinoma (EMC) of the nasal cavity is a rare tumor, and here we describe the first case of EMC of the nasal cavity presenting with epiphora. A case presentation and review of the literature is provided. Methods A case report is described of a 63-year-old man who presented with unilateral epiphora and was found via a thorough history and physical examination to have a nasal tumor. The physical examination consisted of an ocular examination, including probing and irrigation, and a detailed nasal examination (anterior rhinoscopy, nasal endoscopy). The nasal examination was prompted by the patient's report of concurrent nasal symptoms during history taking. Immunohistochemistry subsequently identified the nasal tumor as EMC. A literature search was performed to gain insights into similar malignancies of the nasal cavity. Results Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora. The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision. Conclusion Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity. Unilateral epiphora with concurrent nasal symptoms should prompt nasal cavity examination for the possibility of an obstructive tumor.

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Suggests More Tests for Chest Pain Diagnosis

PEDIATRICS ◽

10.1542/peds.61.1.143b ◽

1978 ◽

Vol 61 (1) ◽

pp. 143-144

Author(s):

Michael F. Elmore ◽

Glen A. Lehman

Keyword(s):

Chest Pain ◽

Physical Examination ◽

Pediatric Patients ◽

Laboratory Studies ◽

Psychiatric Interview ◽

X Ray ◽

Pain Diagnosis ◽

Chest X Ray ◽

Pain Characteristics ◽

Diagnostic Work

Driscoll et al. (Pediatrics 57:648, May 1976) reported a series of 43 patients with chest pain evaluated by history and physical examination, psychiatric interview, screening laboratory studies, ECG, and chest x-ray film. No organic cause was identified in 45% of patients, and various psychiatric aspects of the pain were discussed. The history obtained from pediatric patients is often suboptimal, and specific pain characteristics and associations cannot be defined. We therefore propose that more vigorous diagnostic work-ups are necessary before chest pain can be classed as "idiopathic."

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SENSITIVITY, SPECIFICITY, AND PREDICTIVE VALUE OF PHYSICAL EXAMINATION, CULTURE, AND OTHER LABORATORY STUDIES IN THE DIAGNOSIS DURING EARLY INFANCY OF VERTICALLY ACQUIRED HUMAN IMMUNODEFICIENCY VIRUS INFECTION

PEDIATRICS ◽

10.1542/peds.94.2.274a ◽

1994 ◽

Vol 94 (2) ◽

pp. 274-275

Author(s):

Susan E. Pacheco ◽

William T. Shearer

Keyword(s):

Clinical Trials ◽

Physical Examination ◽

Hiv Infection ◽

Laboratory Studies ◽

Diagnostic Laboratory ◽

Predictive Values ◽

P24 Antigen ◽

Aids Clinical Trials ◽

Sensitivity Specificity ◽

Hiv 1

Purpose of the Study. To determine the HIV vertical transmission rate in an unselected group of infants born to HIV-infected mothers, and to examine the sensitivity, specificity, and positive and negative predictive values of physical examination and diagnostic laboratory studies (HIV culture, serum quantitative immunoglobulins and HIV-1 p24 antigen) in the diagnosis of HIV infection. Study Population. A group of 142 infants referred solely because they were born to HIV-infected mothers were selected for this study. Methods. Epidemiological and clinical data were obtained retrospectively from the Baylor Pediatric AIDS Clinical Trials Group HIV Infection Registry and medical records. The information recorded included results of physical examination and diagnostic laboratory tests (HIV culture, serum quantitative immunoglobulins, and HIV-1 p24 antigen). HIV cultures were performed according to a consensus protocol developed for the National Institute of Allergy and Infectious Diseases AIDS Clinical Trials Group. Results. Of 142 infants whose HIV infection status was known at the time of the study, 17 (20%) had confirmed infection, and 68 (80%) had seroreverted with no evidence of infection. All HIV-infected infants were at least 3 months old when abnormal physical exam findings became apparent (lymphadenopathy and hepatosplenomegaly), but similar findings were noted in an equal number of HIV-uninfected infants. All infected infants available were HIV culture positive by 6 months of age (16/16). There was no positive cultures reported in the infants who seroreverted (32/32). Elevated immunoglobulins (IgG, IgA, IgM) were present by 6 months of age in a high percentage of infected infants. Nearly one-half of the uninfected infants had elevated immunoglobulin levels during the first 6 months of life, but in 50% of the cases it was IgG alone.

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Oximetry and neonatal examination for the detection of critical congenital heart disease: a systematic review and meta-analysis

F1000Research ◽

10.12688/f1000research.17989.1 ◽

2019 ◽

Vol 8 ◽

pp. 242 ◽

Cited By ~ 1

Author(s):

Hernán Camilo Aranguren Bello ◽

Dario Londoño Trujillo ◽

Gloria Amparo Troncoso Moreno ◽

Maria Teresa Dominguez Torres ◽

Alejandra Taborda Restrepo ◽

...

Keyword(s):

Systematic Review ◽

Congenital Heart Disease ◽

Heart Disease ◽

Physical Examination ◽

Congenital Heart ◽

Heart Defects ◽

Meta Analysis ◽

Review Of The Literature ◽

Critical Congenital Heart Disease ◽

Operational Characteristics

Background: Undiagnosed congenital heart disease in the prenatal stage can occur in approximately 5 to 15 out of 1000 live births; more than a quarter of these will have critical congenital heart disease (CCHD). Late postnatal diagnosis is associated with a worse prognosis during childhood, and there is evidence that a standardized measurement of oxygen saturation in the newborn by cutaneous oximetry is an optimal method for the detection of CCHD. We conducted a systematic review of the literature and meta-analysis comparing the operational characteristics of oximetry and physical examination for the detection of CCHD. Methods: A systematic review of the literature was conducted on the following databases including published studies between 2002 and 2017, with no language restrictions: Pubmed, Science Direct, Ovid, Scopus and EBSCO, with the following keywords: oximetry screening, critical congenital heart disease, newborn OR oximetry screening heart defects, congenital, specificity, sensitivity, physical examination. Results: A total of 419 articles were found, from which 69 were selected based on their titles and abstracts. After quality assessment, five articles were chosen for extraction of data according to inclusion criteria; data were analyzed on a sample of 404,735 newborns in the five included studies. The following values were found, corresponding to the operational characteristics of oximetry in combination with the physical examination: sensitivity: 0.92 (CI 95%, 0.87-0.95), specificity: 0.98 (CI 95%, 0.89-1.00), for physical examination alone sensitivity: 0.53 (CI 95%, 0.28-0.78) and specificity: 0.99 (CI 95%, 0.97-1.00). Conclusions: Evidence found in different articles suggests that pulse oximetry in addition to neonatal physical examination presents optimal operative characteristics that make it an adequate screening test for detection of CCHD in newborns, above all this is essential in low and middle-income settings where technology medical support is not entirely available.

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