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Is it unilateral? The presence of unilateral atrophy would suggest hernia surgery, previous orchitis from mumps, gonorrhea, syphilis, tuberculosis or elephantiasis, varicocele, hydrocele, and an undescended testicle.
Is there a ... DIAGNOSTIC WORKUP
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...
Chorea (Greek for “dance”) refers to continuous, rapid, and abrupt jerking movements, which are involuntary and often possess a writhing quality. These movements often interfere with the ability to complete daily activities. A characteristic feature is an inability to... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Seizures are a symptom of some identifiable underlying cause or are idiopathic. Epilepsy is recurrent unprovoked seizures. Seizures may or may not be associated with convulsive activity. Correct classification of the seizure type helps to suggest etiology and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Chorea consists of brief, irregular, nonrhythmic, unsustained involuntary movements that flow from one part of the body to another. Chorea is often accompanied by athetosis, which are slow, writhing, involuntary movements. These movement disorders are thought to result from... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Febrile seizures occur in 3–4% of all children; they often do not require long-term treatment. Each year, between 25,000 and 40,000 children in the U.S. have a first unprovoked afebrile seizure. Most of these children will not have a second seizure and do not require prophylaxis.... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Seizures in the newborn are often difficult to diagnose, because there may only be subtle manifestations. Any insult that affects the brain in this age group can present with seizures, thus the differential diagnosis is quite extensive. One... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The causes of this symptom lend themselves easily to recall. Simply remember the word VINDICATE. There are usually just one or two diseases for each letter.
V—Vascular suggests an infarct of the subthalamic nucleus, which
... READ EXCERPTS »
... This sign is generally considered pathognomonic for anterior horn cell or root disease. It may occur, however, in certain cases of peripheral neuropathy, in electrolyte disturbances, and in myasthenia gravis, especially under treatment. It is also
... READ EXCERPTS »
... The differential diagnosis of this sign is similar to the differential diagnosis of tremors (see page 521), but a few additional possibilities should be kept in mind. Idiopathic myoclonus epilepsy, petit mal epilepsy (with the petit mal
... READ EXCERPTS »
... The causes of this sign can best be recalled by using the mnemonic VINDICATE.
TESTICULAR ATROPHY
V—Vascular conditions bring to mind
... READ EXCERPTS »
... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions cause visible dimpling or wavelike twitching of the skin, but they aren’t strong enough to cause a joint... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical or asymmetrical,... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing periods of inattention. Absence seizures... History and physical examination ... Medical causes
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... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but their incidence usually increases during adolescence and adulthood. Two... History ... Medical causes ... Special considerations ... Pediatric pointers
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... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity isn’t... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial seizures may be... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... Central Nervous System and Vascular Causes
Cerebrovascular disease
Thrombosis
Embolism
Hemorrhage
... READ EXCERPTS »
... Hereditary diseases, especially
Wilson's disease
Huntington's disease
Neuroacanthocytosis
... READ EXCERPTS »
... Epilepsy, also called seizure disorder, is a condition of the brain marked by a susceptibility to recurrent seizures — paroxysmal events associated with abnormal electrical discharges of neurons in the brain.
... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions cause visible dimpling or wavelike twitching of the skin, but they aren’t strong... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
... READ EXCERPTS »
... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical or... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Chorea—brief, unpredictable bursts of rapid, jerky motion that interrupt normal coordinated movement—indicates dysfunction of the extrapyramidal system. Unlike tics, choreiform movements are seldom repetitive but tend to appear purposeful despite their... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times a day, causing periods of inattention. Absence seizures usually begin between ages 4 and... History and physical examination ... Medical causes ... Patient counseling
... READ EXCERPTS »
... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures can occur at any age, but incidence usually increases during adolescence and adulthood.... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity isn’t confined to... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial seizures may be... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Linda M. Savory
Seizures are a common serious neurologic disorder in the outpatient setting. In the United States, approximately 4 million patients suffer at least one seizure and 2 million have suffered two or more.... Approach. ... History. ... Physical examination (PE) ... Testing ... Diagnostic assessment.
... READ EXCERPTS »
... Differential Overview
❑ Generalized (grand mal)
❑ Partial (focal)
❑ Complex partial (temporal lobe)
❑ Absence (petit mal) ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Seizure disorder, or epilepsy, is a condition of the brain characterized by a susceptibility to recurrent seizures (paroxysmal events associated with abnormal electrical discharges of neurons in the brain). Epilepsy is believed to affect 1% to 2%... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations ... Pictures
... READ EXCERPTS »
... Fasciculations are local muscle contractions representing the spontaneous discharge of a muscle fiber bundle innervated by a single motor nerve filament. These contractions cause visible dimpling or wavelike twitching of the skin, but they aren&rsquo... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical or asymmetrical, synchronous or... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity isn’t... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Chorea — brief, unpredictable bursts of rapid, jerky motion that interrupt normal coordinated movement — indicates dysfunction of the extrapyramidal system. Unlike tics, choreiform movements are seldom repetitive but tend to appear purposeful... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Myoclonus — sudden, shocklike contractions of a single muscle or muscle group — occurs with various neurologic disorders and may herald onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic, symmetrical... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness — usually confusion. Psychomotor seizures can occur at any age, but incidence usually increases during... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system (CNS) neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don’t alter the patient’s level of consciousness (LOC). The type and pattern reflect the location of the irritable focus.... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A seizureis a sudden paroxysmal discharge of neurons that causes a transientalteration in neurologic function. This alteration can include changesin level of alertness, sensation, motor activity, and autonomicfunction. Commission on Classification and Terminologyof... Classification of Seizure Types ... Principal Causes of Seizures ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
... READ EXCERPTS »
... Fasciculations, or muscle twitches, are local muscle contractions caused by the spontaneous discharge of a muscle fiber bundle supplied by a single motor nerve cell. These contractions cause visible dimpling or wavelike twitching of the skin, but aren't strong enough to cause a... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Myoclonus—sudden, shocklike contractions of a single muscle or muscle group—occurs with various neurologic disorders and may herald the onset of a seizure. These contractions may be isolated or repetitive, rhythmic or arrhythmic,... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Absence seizures are benign, generalized seizures thought to originate subcortically. These brief episodes of unconsciousness usually last 3 to 20 seconds and can occur 100 or more times per day, causing periods of inattention. Absence seizures usually... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A complex partial seizure occurs when a focal seizure begins in the temporal lobe and causes a partial alteration of consciousness—usually confusion. Psychomotor seizures can occur at any age, but their incidence usually increases during... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... Like other types of seizures, generalized tonic-clonic seizures are caused by the paroxysmal, uncontrolled discharge of central nervous system neurons, leading to neurologic dysfunction. Unlike most other types of seizures, however, this cerebral hyperactivity isn't confined to the... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... Resulting from an irritable focus in the cerebral cortex, simple partial seizures typically last about 30 seconds and don't alter the patient's level of consciousness (LOC). The type and pattern reflect the location of the irritable focus. Simple partial seizures... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
...
The causes of this symptom lend themselves easily to recall. Simply
remember the word VINDICATE. There are usually just one or two
diseases for each letter.
V—Vascular suggests an infarction of the subthalamic
... READ EXCERPTS »
...
This sign is generally considered pathognomonic for anterior horn cell
or root disease. It may occur, however, in certain cases of peripheral
neuropathy, in electrolyte disturbances, and in myasthenia gravis,
especially under treatment. It is also found in healthy states
... READ EXCERPTS »
...
The differential diagnosis of this sign is similar to that of tremors
, but a few additional
possibilities should be kept in mind. Idiopathic myoclonus epilepsy, petit
mal epilepsy (with the petit mal triad), grand mal epilepsy, and hysteria are
... READ EXCERPTS »
...
The causes of this sign can best be recalled by using the mnemonic
VINDICATE.
V—Vascular conditions bring to mind varicoceles, which cause
atrophy on the side of the dilated veins.
I—Inflammation recalls the... Pictures
... READ EXCERPTS »
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