Chapter XI Clinical Diagnosis and Differential Diagnosis

2015 ◽  
pp. 156-170
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis

Picture Recognition Errors in the Differential Diagnosis of Alzheimer’s Disease

2019 ◽  
Vol 30 (3) ◽  
pp. 157-168
Author(s):  
Helmut Hildebrandt ◽  
Jana Schill ◽  
Jana Bördgen ◽  
Andreas Kastrup ◽  
Paul Eling
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Response Bias ◽  
Recognition Task ◽  
Discriminatory Power ◽  
False Alarms ◽  
Picture Recognition ◽  
Recognition Errors

Abstract. This article explores the possibility of differentiating between patients suffering from Alzheimer’s disease (AD) and patients with other kinds of dementia by focusing on false alarms (FAs) on a picture recognition task (PRT). In Study 1, we compared AD and non-AD patients on the PRT and found that FAs discriminate well between these groups. Study 2 served to improve the discriminatory power of the FA score on the picture recognition task by adding associated pairs. Here, too, the FA score differentiated well between AD and non-AD patients, though the discriminatory power did not improve. The findings suggest that AD patients show a liberal response bias. Taken together, these studies suggest that FAs in picture recognition are of major importance for the clinical diagnosis of AD.

scholarly journals Diagnostic accuracy of dual-phase 18F-FP-CIT PET imaging for detection and differential diagnosis of Parkinsonism

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Minyoung Oh ◽  
Narae Lee ◽  
Chanwoo Kim ◽  
Hye Joo Son ◽  
Changhwan Sung ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Fdg Pet ◽  
Brain Activity ◽  
Visual Assessment ◽  
Dual Phase ◽  
Regional Brain ◽  
Parkinsonian Disorders ◽  
Regional Brain Activity ◽  
Delayed Phase

AbstractDelayed phase 18F-FP-CIT PET (dCIT) can assess the striatal dopamine transporter binding to detect degenerative parkinsonism (DP). Early phase 18F-FP-CIT (eCIT) can assess the regional brain activity for differential diagnosis among parkinsonism similar with 18F-FDG PET. We evaluated the diagnostic performance of dual phase 18F-FP-CIT PET (dual CIT) and 18F-FDG PET compared with clinical diagnosis in 141 subjects [36 with idiopathic Parkinson’s disease (IPD), 77 with multiple system atrophy (MSA), 18 with progressive supranuclear palsy (PSP), and 10 with non-DP)]. Visual assessment of eCIT, dCIT, dual CIT, 18F-FDG and 18F-FDG PET with dCIT was in agreement with the clinical diagnosis in 61.7%, 69.5%, 95.7%, 81.6%, and 97.2% of cases, respectively. ECIT showed about 90% concordance with non-DP and MSA, and 8.3% and 27.8% with IPD and PSP, respectively. DCIT showed ≥ 88% concordance with non-DP, IPD, and PSP, and 49.4% concordance with MSA. Dual CIT showed ≥ 90% concordance in all groups. 18F-FDG PET showed ≥ 90% concordance with non-DP, MSA, and PSP, but only 33.3% concordance with IPD. The combination of 18F-FDG and dCIT yielded ≥ 90% concordance in all groups. Dual CIT may represent a powerful alternative to the combination of 18F-FDG PET and dCIT for differential diagnosis of parkinsonian disorders.

ELECTROENCEPHALOGRAPHIC FINDINGS IN BREATH HOLDING SPELLS

PEDIATRICS ◽  
1955 ◽  
Vol 15 (5) ◽  
pp. 595-599
Author(s):  
Niels L. Low ◽  
Erna L. Gibbs ◽  
Frederic A. Gibbs
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Slow Wave ◽  
Clinical Observation ◽  
Seizure Activity ◽  
Breath Holding ◽  
Convulsive Disorders

After reviewing the literature on breath holding spells, it seemed desirable to determine whether any electroencephalographic abnormality is revealed by recordings during sleep in such cases. One hundred twenty-nine children between the ages of 7 months and 11½ years with breath holding spells were examined electroencephalographically while awake and during sleep. Seventy-seven of these children were boys and 52 were girls. All these children but one had normal electroencephalograms. One tracing taken during a breath holding spell is reproduced which shows slow wave but no seizure activity. The clinical diagnosis is discussed and it is concluded that the electroencephalogram in combination with the history and clinical observation is of value in the differential diagnosis between breath holding spells and convulsive disorders.

Using illness narratives in clinical diagnosis

2018 ◽  
pp. 203-219
Author(s):  
Elisabeth Gülich
Keyword(s):  
Differential Diagnosis ◽  
Anxiety Disorders ◽  
Clinical Diagnosis ◽  
Basic Assumption ◽  
Epileptic Seizures ◽  
Illness Narratives ◽  
Panic Attacks ◽  
Patient Interactions ◽  
Narrative Patterns ◽  
Narrative Techniques

This chapter argues that illness narratives are a suitable instrument for differential diagnosis in practice. The study discussed is based on a corpus of doctor–patient interactions, i.e., encounters with patients suffering from epileptic or non-epileptic seizures and/or anxiety disorders, and for most of whom differential diagnosis is very difficult. The basic assumption put forward here is that the types of narrative can give clues to identify the types of seizures or attacks. The focus is on the ‘methods’ patients use in verbalizing the ‘auras’ preceding the seizures and the course of the seizures or attacks themselves. In particular, it pays attention to the procedures of resolving difficulties of verbalization, which occur during the production of the narrative. It demonstrates that preferences in the choice of narrative techniques allow a distinction between patients with epileptic seizures and patients with other types of fits or with panic attacks. Finally it suggests that knowledge of recurrent narrative patterns can help to recognize the syndrome presented, on condition that the doctor encourages narrative reconstructions and listens carefully.

scholarly journals Bilateral acute depigmentation of iris: 3-year follow-up of a case

2018 ◽  
Vol 10 ◽  
pp. 251584141878798 ◽  
Author(s):  
Cemile Ucgul Atilgan ◽  
Pinar Kosekahya ◽  
Mehtap Caglayan ◽  
Nilufer Berker
Keyword(s):  
Differential Diagnosis ◽  
Anterior Chamber ◽  
Female Patient ◽  
Clinical Diagnosis ◽  
Young Women ◽  
Inflammatory Reaction ◽  
Trabecular Meshwork ◽  
Keratic Precipitates ◽  
Iris Depigmentation

Bilateral acute depigmentation of the iris (BADI) usually affecting young women, is a newly defined clinical diagnosis with bilateral symmetrical pigment loss of iris stroma without iris transillumination defect. Herein, we want to share the results of a 3-year-long follow-up of a 23-year old female patient with BADI. She was admitted to our clinic with a complaint of discoloration of both her brown irises. An ocular evaluation of the patient revealed symmetrical pigment deposition in trabecular meshwork. No iris transillumination defect, pupillary sphincter paralysis, keratic precipitates, and inflammatory reaction in anterior chamber were seen. The depigmented iris stroma became repigmented symmetrically after 3-year follow-up period. Although it is rare, BADI should be considered in the differential diagnosis of the diseases with bilateral iris depigmentation.

scholarly journals Seminoma, Sertolioma, and Leydigoma in Dogs: Clinical and Morphological Correlations

2012 ◽  
Vol 56 (3) ◽  
pp. 361-367 ◽  
Author(s):  
Rafał Ciaputa ◽  
Marcin Nowak ◽  
Maciej Kiełbowicz ◽  
Agnieszka Antończyk ◽  
Karolina Błasiak ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Sertoli Cells ◽  
Leydig Cells ◽  
Histopathological Diagnosis ◽  
Biochemical Tests ◽  
Ki 67 ◽  
X Ray ◽  
Testicular Tumours ◽  
Ray Patterns

Abstract The study aimed at presenting the most frequent male gonadal tumours in dogs, their clinical and histopathological aspects, at outlining aetiopathogenesis and differential diagnosis of the tumours. As examples of the most frequently manifested testicular tumours, three clinical cases were presented, involving tumour of interstitial (Leydig) cells, tumour of Sertoli cells, and seminoma. Respective clinical diagnosis employed USG, X-ray patterns, and morphological and biochemical tests. The surgically sampled material was stained with H+E and an attempt was made to establish expression of E-cadherin, calretinin, and Ki-67. It was shown that histopathological diagnosis of testicular tumours in dogs is frequently very difficult and complex and requires multidirectional studies.

scholarly journals DIFFERENTIAL DIAGNOSIS OF ROSACEA AND SKIN TUBERCULOSIS AS AN EXAMPLE OF A CLINICAL CASE

2014 ◽  
Vol 13 (5) ◽  
pp. 203-208
Author(s):  
M. L. Aripova ◽  
S. A. Khardikova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Diagnosis ◽  
Clinical Case ◽  
Clinical Observation ◽  
Skin Tuberculosis

In this paper for a clinical observation of a patient with rosacea, and patients with a flat form of lupus tuberculosis presented a differential clinical diagnosis of tuberculosis of the skin.

scholarly journals Unilateral Laterothoracic Exanthem – Asymmetric Periflexural Exanthem of Childhood – a Case Report and Literature Review

2017 ◽  
Vol 9 (2) ◽  
pp. 49-52
Author(s):  
Sonja Prćić ◽  
Zorica Gajinov ◽  
Anica Radulović ◽  
Milan Matić ◽  
Aleksandra Matić
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Literature Review ◽  
Skin Eruption ◽  
Clinical Diagnosis ◽  
Broad Spectrum ◽  
Maculopapular Rash ◽  
The Body

Abstract Unilateral laterothoracic exanthem (ULE), or asymmetric periflexural exanthem of childhood (APEC), is an uncommon skin eruption that usually occurs in childhood, with unilateral distribution and self limiting course. The etiology of ULE is unknown, but viral cause is suspected. We report a case of ULE in a 4-year-old girl, that was associated with parvo virus B19 infection, and a brief selected literature review. The patient presented with unilateral maculopapular rash on the left side of the body which was asymptomatic and resolved spontaneously within 5 weeks. The clinical diagnosis of ULE may be precise, ruling out a broad spectrum of differential diagnosis, and prevent unnecessary examinations, whereas the patient is informed about the benign self-limiting nature of ULE.

scholarly journals Presence of Skin α-Synuclein Deposits Discriminates Parkinson’s Disease from Progressive Supranuclear Palsy and Corticobasal Syndrome

2021 ◽  
pp. 1-7
Author(s):  
Maria Pia Giannoccaro ◽  
Patrizia Avoni ◽  
Giovanni Rizzo ◽  
Alex Incensi ◽  
Rossella Infante ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Differential Diagnosis ◽  
Progressive Supranuclear Palsy ◽  
Clinical Diagnosis ◽  
Corticobasal Syndrome ◽  
Healthy Controls ◽  
Mri Findings ◽  
Chi Square ◽  
Clinical Diagnostic Criteria

Background: Previous studies reported skin phosphorylated α-synuclein (p-syn) deposits in Parkinson’s disease (PD) patients but not in patients with parkinsonism due to tauopathies, although data on the latter are limited. Objective: We aimed to assess the presence of skin p-syn deposits in patients with clinical diagnosis of parkinsonism usually due to tauopathy and PD. Methods: We consecutively recruited 26 patients, 18 fulfilling clinical diagnostic criteria of progressive supranuclear palsy (PSP) and 8 of corticobasal syndrome (CBS), 26 patients with PD, and 26 healthy controls (HC). All subjects underwent skin biopsy to study p-syn deposits in skin nerves by immunofluorescence. Results: Skin p-syn deposits were present in only two of the PSP/CBS patients and none of the HC. Conversely, all PD patients showed p-syn deposition (p <  0.001, Chi-square). The two p-syn positive patients were diagnosed with PSP and CBS, respectively. Although clinical and MRI findings supported these diagnoses, both patients had some atypical features more typical of synucleinopathies. Conclusion: The detection of skin p-syn deposits may help in the differential diagnosis of parkinsonism. Indeed, in this study, all PD patients and only two out of 26 with a clinical diagnosis of PSP/CBS had skin p-syn deposits. Furthermore, these two patients showed clinical features that could suggest an atypical synucleinopathy presentation or a mixed pathology.

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