Profuse Sweating Ebooks Catalog
Rickets A condition caused by deficiency of vitamin D, especially in infancy and childhood, with disturbance of normal ossification. The disease is marked by bending and distortion of the bones under muscular action, by the formation of nodular enlargements on the ends and sides of the bones, by delayed closure of the fontanelles, pain in the muscles, and sweating of the head. Vitamin D and sunlight together with an adequate diet are curative, provided that the parathyroid glands are functioning properly. eu
A 10-year-old right-handed male without a significant past medical history was referred for evaluation of possible nocturnal seizures His seizures began at 7 years of age and have occurred almost exclusively during sleep, usually within 2 hours of falling asleep The stereotyped episode involves rocking and bicycling motions, gagging, rolling of the eyes, and profuse sweating lasting approximately 2 minutes These episodes have occurred on average three times per week, but recently have become more frequent He has had two similar episodes that have occurred while awake The patient's previous evaluation included two routine sleep-deprived EEGs and a 1 .5T noncontrast MRI of the brain, all of which were interpreted as normal Other laboratory tests included a complete blood count and comprehensive metabolic profile, which were also normal His physical and neurologic examination is unremarkable, but his family history is significant for a maternal aunt and brother with epileptic seizures...
Night terrors are most commonly seen in children between 5 and 10 years of age. The disorder also occurs in the first 3 hours of sleep in stages 3 or 4 of slow-wave sleep. It may be confused with complex partial seizures. The cause is not known, but there is a familial predisposition. As with sleepwalking, night terrors can be associated with disturbed sleep and a result of disordered breathing or periodic leg movements. Night terrors do not appear to be related to the presence or development of epilepsy or other neurologic or psychiatric disorders. Approximately 3 of all children have this disorder. The child often screams and then sits up. The child continues to scream and appears to be terrified. There are signs of increased sympathetic activity such as excessive sweating and dilated pupils. The attack can last up to 10 minutes, after which the child falls back to sleep. When awakened, the child has no recollection of the event.
Autonomic phenomena associated with absence seizures include pupil dilatation, pallor, flushing, sweating, salivation, piloerection, and even urinary incontinence (21, 24). Neither the autonomic changes nor the automatisms allow one to distinguish absence seizures from other seizure types.
One of these, Rett's syndrome, is characterized by autistic dementia, gait apraxia, stereotyped hand movements, and bizarre attacks involving hyperventilation, limb and truncal jerking and profuse sweating. Likewise, seizures are a frequent clinical feature in patients with Huntington's disease starting in childhood or adolescence or with Wilson's disease with juvenile onset.
Sleep terrors are episodes arising abruptly from sleep of apparent terror. Screaming and agitated behavior with attempts to leave the bed or the room are characteristic, and tachycardia, mydriasis, and sweating are common. The patient is usually inconsolable and partly or completely unresponsive. Injury during the episode is a potentially serious complication due to extreme agitation and escape behavior, and patients may react violently to attempts to restrain them (Kales et al., 1980b). Morning amnesia is characteristic although some patients vaguely recall a terrifying image or situation and occasionally have more detailed recall of dream-like events. Sleep terrors occur once per week or more frequently in about 1-2 of children between the ages of 6 and 14. Some persons continue to have sleep terrors into adulthood and in occasional cases, the onset of the disorder is during the adult years.
A variety of clinical phenomena have been reported to occur in association with the motor spasms. These include autonomic changes (heart rate alterations, cyanosis, pallor, sweating, and flushing), respiratory rate changes, vocalizations (crying, laughter, and grunting sounds), hiccups, smiling, grimacing, tongue and mouth movements, and ocular events (eye deviation, nystagmus, eye opening or closing, pupillary dilation, and tearing).
Panic attacks may (in common with epileptic seizures) be described as paroxysmal events. They are discrete periods of intense fear or emotional discomfort, accompanied by a range of somatic symptoms including palpitations, trembling, a feeling of shortness of breath (which may be associated with hyperventilation), sweating, feelings of choking and psychological symptoms including depersonal-ization, fear of losing control and fear of dying. The attacks occur spontaneously, without warning, and although they may occur in situations in which they have previously occurred, when the patient is concerned that an event may happen, they may also occur unexpectedly. Individual panic attacks are self-limiting although estimates of duration vary. Retrospective estimates by sufferers suggest an average duration of between 10 and 20 minutes. However, a prospective study reported considerably longer attacks, with a mean of between 15 and 50 minutes (Taylor et al., 1986). Whilst some people...
The main form of neurocardiogenic syncope is vasovagal syncope this is the commonest cause of loss of consciousness. There is usually a clear precipitating factor, such as prolonged standing, a hot environment, fright, or the sight of blood. Vasovagal syncope typically begins with the prodrome of nausea, clamminess, sweating, tunnelling and loss of vision (blurred or black), light headedness, and tinnitus. The patient may look pale and sweaty. In the event itself, there is reduced muscle tone, causing the eyes to elevate and the patient to slump to the ground. There may be a few small-amplitude and brief myoclonic jerks during the anoxic phase, which may easily be misinterpreted as an epileptic seizure. Consciousness is usually regained within a few seconds. Amnesia, drowsiness, and confusion are usually only brief. Injury and incontinence occasionally occur, but lateral tongue biting is very unusual.
Benign Childhood Seizures with Affective Symptoms (89). This is reported to have its onset between 2 and 9 years of age and is characterized by multiple, usually short, daytime and nighttime seizures in which the predominant symptom appears to be fear or terror, accompanied by autonomic disturbances (pallor, sweating, abdominal pain, and salivation), arrest of speech, and mild impairment of consciousness with automatisms. Interictal EEG shows sharp and slow wave complexes similar to those in rolandic epilepsy but located in the frontotemporal and parietotemporal electrodes. Remission in 1 to 2 years from onset is expected. This is likely to be an intermediate phenotype between Panayiotopoulos syndrome and rolandic epilepsy.
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