extreme irritability
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PEDIATRICS ◽  
1975 ◽  
Vol 56 (1) ◽  
pp. 108-110
Author(s):  
Sudesh P. Makker ◽  
John D. Lubahn

Certain common but seldom recognized clinical features of renovascular hypertension peculiar to infancy are emphasized in this communication from the observations made in a 9-month-old infant. Failure to thrive, extreme irritability, hypotonia, anorexia, vomiting, diarrhea, respiratory distress, and congestive heart failure are common clinical findings. Unless the physician is aware of this symptomatology or blood pressure is routinely obtained in all infants, the condition is likely to be missed. Renovascular hypertension is malignant and carries a high mortality but if diagnosed early may be cured by surgical intervention.


1880 ◽  
Vol 26 (114) ◽  
pp. 254-257
Author(s):  
T. B. Worthington

Charles G., æt 37, married, a farm labourer, was admitted on the 22nd September, 1877, suffering from epilepsy. His parents are both living, and are not subject to fits; but one of his brothers has died of epilepsy, and another is afflicted with the disease. He is the father of nine children, all still alive, and several of whom are epileptics. When examined on admission, he was found to be a thin but muscular man; he had no thoracic disease, and his digestive functions were unimpaired. His mental state was returned as epileptic dementia, and he was incoherent, stupid, slovenly, and dirty. During his stay in the asylum, owing to his extreme irritability of temper, he often quarrelled with the other patients, and attendants. His fits were not very numerous, and during a period of six months, in which an accurate record of the number was kept, he only had 10 in the daytime, and 36 at night; but they were severe, and generally left him prostrate for some hours. He gradually became more demented, and during the last three months of his life looked extremely anæmic. His chest was twice examined, but nothing abnormal could be detected in his thoracic viscera. He complained on one occasion of pain in his left lumbar region, but when his abdomen was examined he said it was on the other side. His urine was clear, and he never passed any blood. He did not take his food well latterly, and often vomited after his meals. He was only confined to bed when suffering from great prostration, caused by the severity of the epileptic paroxysms. On the 11th February, 1880, he was about as usual, and out in the airing courts before and after dinner; he took his supper at six o'clock, and went to bed at 7.30; he slept from 10 till 3 the next morning, when he had an ordinary fit, and at six he was returned, by the night attendant, as having had another; he had been awake, and had spoken in the interval. He never recovered consciousness after this, and presented all the symptoms of brain pressure; he had stertorous breathing, his pulse was slow and feeble, and he had total loss of reflex action. He only lived six hours.


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