Nosology of febrile convulsions.
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Biomedical subjects
Publications and source records attributed to D P Addy.
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An 11-year-old girl developed a severe brainstem encephalopathy thought to be due to multiple sclerosis. She has been left with a severe long-standing bulbar palsy and a permanent tracheostomy. A new operation of laryngeal closure is described which gave relief from recurrent aspiration pneumonia and cardiorespiratory failure.
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Three cases of clonidine overdosage are described. The clinical features were typical of those described in the literature. Though all three patients were severely poisoned, treatment was supportive except for intravenous atropine. Other more aggressive treatment regimen are discussed but it is emphasized that these are rarely, if ever, required.
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Nonketotic diabetes mellitus developed in a "small-for-dates" baby at the age of 6 days. The disease was controlled initially with insulin but beginning at the age of 40 days, chlorpropamide was substituted gradually for insulin over a 24-day period. Treatment was stopped at the age of 13 weeks and the baby remained well thereafter. It is suggested that chlorpropamide might be useful in the treatment of transient neonatal diabetes.
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A diagnosis of cystic fibrosis was incorrectly made after false-positive sweat tests in 14 children. 13 of these children had been tested at hospitals where it seems likely that sweat tests were not done very often. All the children had normal sweat-electrolyte values when the test was repeated at a regional paediatric centre where approximately 250 sweat tests are done each year. In 5 cases, detailed testing of pancreatic function was normal. None of the children had typical chest disease and only 2 had gastrointestinal symptoms. In the absence of the typical clinical features of the disease a diagnosis of cystic fibrosis should be made with extreme caution and only after meticulous testing of both sweat electrolytes and pancreatic function.
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