It is apt to misdiagnose the epilepsy to frighten syndrome

It is apt to misdiagnose the epilepsy to frighten syndrome
Nerve recovery department of healthcare hospital for women children of Guangdong Province Yi AiWen Chang YanQun
Patient Wang, female, 15 years old. Twinkle while touching the upper lip promptly in several days since growing and the head inclines backward; Shake all over at the time of the unexpected sound, four limbs are stretched and hardened at the same time, return to normal about several seconds later. Infant grow normal of the same age children lag behind, about a and a half year old can hold alone, 3 year old can support, stand and support conduct, 4 year old can alone competent. Walk alone, as general normal people of meeting will cause external world reacted to frighten stimulate, will still stretch and harden four limbs, stand upright and fall forward or backward, consciousness is sober, but can't reflect protective support. Infant's intellectual development is similar to children of the same age, can go to school normally, but does not dare to participate in the sport activity and cross the road alone. There is no similar medical history in the family. Misdiagnose for epilepsy and treat over 5 o'clock, symptom meet that obviously take a favorable turn.
It is keeping to the point for physical examination to answer, can know, describe situation fall each time, alone competent and steady, can run slowly, can pairs of foot beat 40cm to be wide. Knock and hit the upper lip appears twinkly and the head, upper limb recede; It is unexpected for sound, it make it last back or after greatly admire,can resume 2~3 second, neural systems inspection has not been seen unusually. And dynamic electroencephalogram see unusual when the piece, bring out clinical break out, electroencephalogram meet unusual also the same period. The head MRI has not been seen unusually. Diagnose: Frighten the syndrome heavy-duty.
It is a group of diseases taking unusually frightening reacting as characteristic to frighten syndrome, it is light, heavy and two type to divide. It is shown as when the external world stimulated to appear suddenly, the infant frightened the movement range to increase that light, but does not fall down; Can fall down suddenly in heavy-duty, and it is frequent to break out, but unconscious obstacle, there is urinary incontinence occasionally, often accompany night one burst of contractions of skin breaking out repeatedly. Patient's movement and intelligence are normal in development, while breaking out the electroencephalogram is very normal or presents the non- specific change, there is not epilepsy kind that discharge. Bring out, frighten react, lead all and part lead unite appear the intersection of skin and the intersection of electricity and false difference, resume the intersection of background and wave 1~2 second. Skin electric picture and neural image learn to check not unusual.
After offering desensitization massage treatment to patient for two days, knock it while hitting the upper lip, patient's symptom is slightly lightened. And then add for the west of nitre of chlorine to melt 0.01mg/kg.d treatment, future trouble frightens symptom and has not seen obvious improvement in two days. Gradually adding amount to 0.02mg/kg.d, 0.05mg/kg.d,until adding amount to 0.1mg/kg.d,take orally after 1 day, patient is knock for for back and pushing away while hitting suddenly, four limbs are stiff to disappear, does not fall down again.
This should pay attention to, distinguish at the clinical rare disease. When meeting the suspicious patient that excessively frightens, inquire the medical history is very important in detail. About the cause of disease, the scholar thinks that relates to spiritual factor and heredity. Might subside or lack onset as inhibitory activity that is advanced for centre vs. brain stem like when there increase and have something to do is brain stem excitability.
Melt and show curative effect in the west of nitre of chlorine. Standard patient take third the intersection of fifth and sour the intersection of sodium and 5 year over good result, give chlorine nitre to treat after the one week while being stable, symptom is obviously lightened, at present still in following up a case by regular visits to closely.
|