Nelson Pediatric Symptom-Based Diagnosis

Altered Mental Status

Altered Mental Status Altered mental status (AMS) refers to a broad range of nonspecific symptoms indicating a change in brain function from a patient’s baseline and can include confusion, alteration in consciousness, disorientation, decreased awareness, amnesia, and change in behavior.…

Movement Disorders in Childhood

The clinical evaluation of childhood movement disorders depends on the crucial step of phenomenology that precedes and guides evaluation and management. Historically, many of the chronic movement disorders were identified as phenotypic syndromes based on clinical presentation, associated symptoms, and…

Paroxysmal Disorders

Paroxysmal disorders can be broadly classified into epileptiform and nonepileptic events. The nonepileptic episodes are often referred to by the generic term spells . They may mimic epileptic seizures but are not associated with the typical rhythmic EEG patterns characteristic…

Hypertonicity

Definitions Tone is defined as resistance to passive stretch while a patient is attempting to maintain a relaxed state of muscle activity. Tone can be divided into postural tone, which represents the steady flexion or extension of a joint caused…

Stroke

Stroke is a sudden focal neurologic syndrome caused by an abrupt and critical interruption of the normal metabolic function of the central nervous system (CNS), typically due to ischemia or hemorrhage. Depending on where in the CNS this interruption occurs,…

Rhabdomyolysis

Rhabdomyolysis Rhabdomyolysis is an acute muscle injury resulting in myocyte cell death with subsequent release of toxic intracellular compounds producing muscle and systemic symptoms. This differs from hyperCKemia, in which there is elevated creatine kinase in the serum secondary to…

Hypotonia and Weakness

Muscle Weakness and Hypotonia As a symptom, hypotonia may be overt in its presentation, with the manifestations of low muscle tone apparent to family and the medical team alike. Other times, hypotonia may be insidious, subtly presenting to an examiner…

Headaches

Headaches are classified as primary or secondary. Primary headaches are benign, are not caused by underlying disease or structural problems, and include migraines, tension-type headaches (TTHs), and the trigeminal autonomic cephalgias (TACs). Migraines and TTHs are the most common primary…

Chronic Pain

Chronic Pain Chronic pain is often defined as recurrent or persistent pain lasting ≥3 months. The child may have a definable medical condition but often does not have a specific disease diagnosis or identifiable etiology for the pain other than…

Autistic-like Behaviors

Autism spectrum disorder (ASD) is a neurobiologic disorder with onset in early childhood; it is characterized by impaired social communication and interaction accompanied by restricted and repetitive behaviors. With definitions that vary dependent on agencies, schools, and clinicians, there is…