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5041. Head Lice

%. There is no evidence that head lice have a preference for either clean or dirty hair. Risk factors include: Age less than 12 years. Female gender. Families with four or more children. Lower socio-economic status. Long hair. Presentation [ ] Many infestations are totally asymptomatic. Presentation is usually when adult lice or nits have been seen. Others present with itching. Itching of the scalp is not sufficient to diagnose active infestation. Itching may not develop for several weeks or months after becoming (...) infested and may persist for days to weeks after successful eradication of head lice. Nits alone are not sufficient to diagnose active head lice infestation because it is difficult to distinguish between dead and live eggs with the naked eye. A diagnosis of active head lice infestation can only be made if a live head louse is found. Detection combing (systematic combing of wet or dry hair with a detection comb) should be used to confirm the presence of lice: A fine-toothed (teeth 0.2-0.3 mm apart

2008 Mentor

5042. Headache

but there are no published studies which support these numbers. The classification includes both episodic and chronic TTH. TTH characteristics are that they are bilateral, pressing or tightening in quality, mild-to-moderate in intensity and with no nausea. They are not aggravated by physical activity although there may be pericranial tenderness and sensitivity to light or noise. [ ] Migraine See separate article. Migraine headaches tend to be unilateral, throbbing and disproportionately disabling. Nausea is common (...) headache brought on by exercise and lasting 5 minutes to 48 hours. It occurs particularly in hot weather or at high altitude. Due to its sudden onset, SAH may need to be excluded. At altitude it is essential to consider , and in view of their seriousness these should be the first-line diagnoses until disproved. Primary sexual headache (benign vascular sexual headache or coital cephalgia): a headache precipitated by sexual activity, usually starting during intercourse and peaking at orgasm. It may have

2008 Mentor

5043. Haemophilia B (Factor IX Deficiency)

haemophilia A, immune tolerance induction has a poor response rate (25%) and there is a risk of nephrotic syndrome. [ ] Lifestyle has to be adapted to accommodate the disease. Contact sports should be avoided as well as sports and pastimes in which there is significant risk of trauma. Manual labour should be avoided. Complications [ ] The bleeding can cause many problems, including neurological deficits; however, a very common finding is that recurrent bleeding into joints leads to destruction (...) objections. One is that 50% of aborted fetuses would be normal. The other is that abortion for a condition that is associated with a fairly normal lifestyle, with some restriction of 'rough' activity and a life expectancy of 60 years or more, is ethically unsound. Reproductive choices for affected families are complex. There is the question of passing on the gene either from mother or father and the possibility of transmission of HIV if the man has been infected. [ ] A survey in the Netherlands (which

2008 Mentor

5044. Epilepsy in Children and Young People

their seizure type(s) and epilepsy syndrome, and the likely prognosis. [ ] Children and young people with learning disabilities [ ] Diagnosis of epilepsy in children and young people with learning difficulties can be difficult. Confusion may arise between stereotypical or other behaviours and seizure activity. Particular attention should be paid to the possibility of adverse cognitive and behavioural effects of anti-epileptic drug (AED) therapy. All children and young people with epilepsy and learning (...) , hypernatraemia, hyponatraemia, hypoglycaemia, hypocalcaemia, hypomagnesaemia, toxins. Trauma. Metabolic disorders. Trigger factors Watching television and lack of sleep are two common triggers. It has been shown that observing the set with one eye covered prevents the occurrence of these seizures. Presentation When a child or young person presents with a seizure, a thorough physical examination should be performed, including cardiac, neurological and mental state. An assessment of development is important

2008 Mentor

5045. Epilepsy in Adults Full Text available with Trip Pro

'. There are a number of other forms of epilepsy, especially in children. See the separate article for further information. Patients with learning disabilities [ ] Diagnosis of epilepsy in patients with learning difficulties can be difficult. Confusion may arise between stereotypical or other behaviours and seizure activity. Particular attention should be paid to the possibility of adverse cognitive and behavioural effects of anti-epileptic drug (AED) therapy. All adults with epilepsy and learning disabilities (...) should have a risk assessment - eg, bathing and showering, preparing food, using electrical equipment, the suitability of independent living. Epidemiology [ ] The prevalence of active epilepsy is 5-10 cases per 1,000 - but with 5-30% of these misdiagnosed as having epilepsy. [ ] Epilepsy most commonly starts in children or in people older than 60 years of age. Epilepsy is much more common in people with a learning disability. Epilepsy is a feature of over 200 genetic disorders, accounting

2008 Mentor

5046. General Learning Disability Full Text available with Trip Pro

in patients with learning disabilities: Schizophrenia. Anxiety and depressive disorders. Personality disorder. Early-onset dementia. Autism. Hyperactivity and attention deficit hyperactivity disorder. Eating disorders, including rumination, food faddiness, anorexia nervosa and bulimia nervosa.. Behavioural Difficulty accessing care and support: the stigma associated with learning disabilities may lead to an unwillingness for those affected to use specialised services or self-identify as having learning (...) problems. Abnormalities of movement. Speech, hearing and visual impairment. Epilepsy. Urinary and faecal incontinence. Increased risk of obesity, fractures. Poor oral health (including dental caries and loss of teeth). Poor diet, increased rates of constipation and gastro-oesophageal reflux disease. Lack of physical exercise. Sleep disorders. Increased risk of chronic obstructive pulmonary disease. More frequent physical disorders. The most common physical health problems are epilepsy, mobility

2008 Mentor

5047. Fragile X Syndrome

behaviours, emotional lability and aggressive or self-aggressive behaviours. Affected girls and women are more likely to have problems with shyness or social withdrawal. In some cases, those affected may also have a diagnosis of attention deficit hyperactivity disorder (ADHD) or an autism spectrum disorder. Around 30% of affected males have autism and as many again may have an autism spectrum disorder. [ , ] Other symptoms may include hand-flapping, repetitive actions, clumsiness, avoidance of gaze (...) Guidelines. You may find one of our more useful. In this article In This Article Fragile X Syndrome In this article Fragile X syndrome (FXS) is an inherited condition which presents with typical behavioural, developmental and physical problems. Genetics [ , ] FXS is the most common cause of sex-linked, general learning disability. It is one of a number of repeat expansion disorders. In DNA coding it is common to see repeated sequences of the nucleotides that make up the genetic strand. In FXS

2008 Mentor

5048. Extradural Haemorrhage

Association (BMA) has advised for many years that amateur and professional boxing should be banned as well as mixed martial arts. [ ] Boxing is by far the most common cause of head injures but the second most common cause in sport is equestrian activities. Appropriate immediate management is possible at large events but many injuries occur in unsupervised leisure settings. [ ] Did you find this information useful? Thanks for your feedback! Why not subscribe to the newsletter? Email address * We'd love (...) pupils. Facial nerve injury. Weakness of limbs. Other focal neurological deficits include aphasia, visual field defects, numbness and ataxia. Always remember patients with EDH seen in casualty may also have a traumatic cervical spine injury . A haematoma in the spinal column will produce compression of the cord. There may be radicular symptoms or a complete cord compression. Presentation may include: Weakness. Numbness. Alteration in reflexes. Urinary incontinence. Possibly both urinary and faecal

2008 Mentor

5049. Noonan's Syndrome

of attention deficit hyperactivity disorder (ADHD) is reported to be higher compared to unaffected siblings. [ ] There is wide variation in the intellectual ability in adults with NS, with IQ scores ranging from 65 to 121. Most individuals are friendly, cooperative and willing to please but may have a moderate level of impairment of social cognition. Eye and skin [ ] Eyes are frequently affected, with more than 70% having a refractive error, usually myopia. Follicular keratoses over the extensor surfaces (...) find one of our more useful. In this article In This Article Noonan's Syndrome In this article Noonan syndrome (NS) is a common genetic disorder with multiple congenital abnormalities. It is characterised by congenital heart disease, short stature, a broad and webbed neck, sternal deformity, variable degree of developmental delay, cryptorchidism, increased bleeding tendency and characteristic facial features that evolve with age. [ ] The term 'male Turner syndrome' is sometimes used as a synonym

2008 Mentor

5050. Nightmares and Bad Dreams

. This is particularly so for young children but they can be disruptive to the whole family. Explanation and reassurance are often helpful particularly for parents who can then in turn be more reassuring to the affected child. It is important to distinguish nightmare disorder from (which are episodes of panic and confusion, with difficulty waking or bringing to awareness, and of which the sufferer has no recollection). The ICD-10 definition of the diagnosis of a nightmare disorder is detailed below: ICD-10 (...) or predisposing to nightmares (this may also cause night terrors). [ ] . [ ] Depressive illness with melancholic features may be associated in adults. [ ] REM sleep behaviour disorder (a problem affecting particularly older adults). [ ] Investigations Investigations are not usually necessary if the diagnosis is clear from the history. However, bear in mind that: Night terrors (sleep terrors) and sleepwalking (which differ from nightmares, as explained above) have been linked to physical sleep disorders

2008 Mentor

5051. Nocturnal Enuresis in Children

syndrome such as Down's syndrome. Even without gross developmental delay, there is more likely to be persistent bedwetting in children with delayed developmental milestones, premature delivery or behavioural disorders such as hyperactivity or inattention deficits and autism spectrum disorders. There may be neurological problems such as spina bifida or cerebral palsy. Those with physical problems are more likely to have daytime enuresis or trouble with encopresis. Physical problems are a rare cause (...) nocturnal enuresis in whom constipation and UTI have been excluded or treated. History of recurrent UTIs. Abnormal renal ultrasound results (not indicated as an investigation for isolated nocturnal enuresis). Known or suspected physical or neurological problems. Comorbid conditions (eg, faecal incontinence, diabetes, and attention, learning, behavioural, or emotional problems), or family problems. Those who have not responded to treatment in primary care after six months. Management guidelines below

2008 Mentor

5052. Night Terrors and Parasomnias

allegations. One Norwegian random population survey reported a lifetime prevalence of 7.1% and a current prevalence of 2.7%. [ ] As with sleep-related eating disorder, this is a confusional arousal disorder in which the higher reasoning centres of the cortex are deactivated, whilst more primitive activities such as sex and eating are disinhibited. One study found that polysomnography recorded several abrupt and spontaneous arousals from slow-wave sleep. [ ] Sleep-related eating disorder This condition (...) and without treatment. Treatment of comorbidities such as sleep breathing disorders may be helpful. Promoting a regular sleep pattern in a stable environment is important. There is little evidence that sedative medication is helpful in the long-term management of children with night terrors and other sleep disorders. Tricyclics are occasionally used for severe symptoms or where the condition affects daytime performance (eg, at school). Patients with underlying physical or psychiatric disease may benefit

2008 Mentor

5053. Neurofibromatosis

of cognitive problems in NF is not known. Children and adolescents with NF are more likely to suffer attention deficit hyperactivity disorder (ADHD); incidence is high, at around 40%. [ ] Cardiovascular problems Congenital heart disease (pulmonary stenosis and hypertension) are associated with NF. Renal artery stenosis occurs in approximately 2% of those with NF1, so NF should be a diagnosis considered in hypertensive children, young adults and pregnant women, and refractory hypertension in older (...) problems such as hypertension, epilepsy or ADHD. Surgery Neurofibromas Neurofibromas that press on vital structures, obstruct vision, or grow rapidly need urgent attention. Plexiform neurofibromas can be difficult. They often recur after resection because there are residual cell rests deep in soft tissues. Neurofibromas on the scalp, along the hairline, or around the waist where clothes rub can cause irritation and discomfort and are worthy of removal. In NF2, there has been some success with cochlear

2008 Mentor

5054. Paediatric History

Assoc. 2005 May-Jun12(3):299-305. Epub 2005 Jan 31. ; Pediatric generalized anxiety disorder: epidemiology, diagnosis, and management. Paediatr Drugs. 200911(3):171-83. doi: 10.2165/00148581-200911030-00003. ; Recognizing and treating anxiety disorders in children. Pediatr Ann. 2005 Feb34(2):147-50. RIGHT funny i dont know if its funny or not max ADHD AND DISABLED just had a back operation itchy feet terrible you might laugh.but 50-100 yards and ache .ummm you all might think it funny ment (...) . In this situation you should remember that the child is your patient, not the parent(s), and focus your attention on their story whilst engaging the parent(s) and maintaining their trust and confidence. With teenagers, it may be difficult to give appropriate autonomy without offending the parent(s). With older teenagers it may be necessary to invite the parent(s) to leave so that further history can be taken, or to achieve privacy by using the opportunity of the examination to separate the teenager from

2008 Mentor

5055. Paediatric Examination

the nature and cause and extent of any illness or injury). [ ] The examination of children for other specific purposes such as: To establish fitness for education or certain activities. To examine for signs of sexual abuse in child protection cases. However, this is not an absolute distinction. Whether ill or well, the examining doctor should have a good working knowledge of routine examination and normal findings in children at different ages. Problems with development, behaviour and growth may thus (...) be identified opportunistically whilst examining an ill child. Doctors working with children should have a good knowledge of normal developmental milestones, as well as routine physical development and findings at different ages. General points It is important to have established rapport with parents and child when taking the history. The approach to the examination will be determined by the age, level of development and level of understanding of the child. Inspection and observation are the most important

2008 Mentor

5056. Obstructive Sleep Apnoea in Children Full Text available with Trip Pro

airway obstruction during sleep, which affects the child's ventilation and disrupts their normal sleep pattern. In general, all children with OSAS will snore. OSAS is a common and serious cause of metabolic, cardiovascular and neurocognitive morbidity in children. OSAS in children is a similar condition to the form in adults but there are important differences too. There is sleep disruption due to respiratory pauses that last more than ten seconds. There may also be hypopnoeic episodes (usually >5-10 (...) If left untreated, OSAS is associated with adverse effects on growth and development, including deleterious cognitive and behavioural outcomes. [ ] Evidence exists also that untreated OSAS impacts on cardiovascular risk. Daytime hyperactivity. Cognitive deficits. Cardiovascular problems - eg, hypertension, left ventricular hypertrophy, raised pulmonary artery pressure. Failure to thrive. Association with insulin resistance. Some studies have shown that children with OSAS have greater impulsivity when

2008 Mentor

5057. Wolf-Hirschhorn syndrome

. * )" for="internaute" >You are ( * ) * " for="autre" >If you have selected the �Other� category, please specify which type of user you are: * * " for="email" >Email address: * Topic of your comment * " for="" > Topic of your comment * Epidemiology data Summary and related texts Related genes Clinical signs Nomenclature and/or coding Your message * ( 3000 characters remaining)" for="commentaire" > Your message * ( 3000 characters remaining) Attention Only comments seeking to improve the quality and accuracy (...) of information on the Orphanet website are accepted. For all other comments, please send your remarks via . Only comments written in English can be processed. Check this box if you wish to receive a copy of your message * " for="captcha" >Please reproduce the text below: * Wolf-Hirschhorn syndrome Disease definition A developmental disorder characterized by typical craniofacial features, prenatal and postnatal growth impairment, intellectual disability, severe delayed psychomotor development, seizures

2003 Orphanet

5058. Pelizaeus-Merzbacher disease

deficit. It is classified into three sub-forms based on the age of onset and severity: connatal, transitional, and classic PMD (see these terms). ORPHA:702 Classification level: Disorder Synonym(s): Diffuse familial brain sclerosis PMD Pelizaeus-Merzbacher brain sclerosis Sudanophilic leukodystrophy, Paelizeus-Merzbacher type Prevalence: 1-9 / 1 000 000 Inheritance: X-linked recessive or X-linked dominant Age of onset: All ages ICD-10: E75.2 OMIM: UMLS: C0205711 MeSH: D020371 GARD: MedDRA: 10067610 (...) fields. * )" for="internaute" >You are ( * ) * " for="autre" >If you have selected the �Other� category, please specify which type of user you are: * * " for="email" >Email address: * Topic of your comment * " for="" > Topic of your comment * Epidemiology data Summary and related texts Related genes Clinical signs Nomenclature and/or coding Your message * ( 3000 characters remaining)" for="commentaire" > Your message * ( 3000 characters remaining) Attention Only comments seeking to improve

2000 Orphanet

5059. Testing a Possible Cause of Reduced Ability of Children to Process Speech in Noise

hyperactivity disorder (ADHD). Many of these children have difficulty with tasks that challenge the auditory system. It is estimated that 3 to 7 percent of children have difficulty with auditory processing as a major factor interfering with education (Chermak and Musiek, 1997). Pinpointing physiological causes of auditory processing difficulty has been elusive. Intervention is hampered by the lack of knowledge of possible physical causes and therefore intervention addresses systems rather than causes (...) speaking together; two words presented at the same time, one to each ear (child must repeat both words); and two sentences presented at the same time, one to each ear (child must repeat sentence presented to chosen ear). The only risk in this study is tiredness from listening. Condition or disease Central Auditory Disease Healthy Detailed Description: Five to ten percent of school-age children in the United States are identified as having learning disability and 10 to 20% have attention deficit

2000 Clinical Trials

5060. Eye Blink Response in Healthy Volunteers and Adults With Schizophrenia

that patients with schizophrenia have deficits in acquiring the trace form of the task as opposed to the delay, where we assume they would be unimpaired as compared to normal controls. We would also like to study heart rate and skin conductance changes that occur during conditioning, since patients with schizophrenia have showed impaired autonomic function. We also plan to study neurophysiological correlates of these behaviors with evoked response potentials (EP) and eventually functional magnetic resonance (...) motivation and attention are frequently confounding factors in the study of memory processes. Patients with schizophrenia have been reported to have hippocampal and possibly cerebellar structural and functional abnormalities, however eyeblink conditioning has been minimally studied in this patient population. We expect implicit forms of memory (cerebellum dependent) to be relatively spared as compared to declarative memory (hippocampus dependent) in schizophrenia. We would like to test the hypothesis

1999 Clinical Trials

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