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A case of mistaken identity: pseudodementia is really predementia.
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Exfoliative cheilitis.
Exfoliative cheilitis is an uncommon condition affecting the vermilion zone of the upper, lower or both lips. It is characterized by the continuous production and desquamation of unsightly, thick scales of keratin; when removed, these leave a normal appearing lip beneath. The etiology is unknown, although some cases may be factitious. Attempts at treatment by a wide variety of agents and techniques have been unsuccessful. Three patients with this disease are reported and its relationship to factitious cheilitis and candidal cheilitis is discussed.
Single case experimentation: a seventeenth century example.
This paper describes a seventeenth century case which contains most of the features of a modern single case experiment. The method employed was similar to the forced choice technique now used to detect 'hysterical' sensory symptoms.
Symptom-validity testing of feigned sensory or memory deficits: a further elaboration for subjects who understand the rationale.
Symptom-validity testing has been used to detect feigning in patients claiming sensory and memory deficits. Such patients typically give significantly fewer correct responses on forced-choice testing than would be expected by chance. Some subjects have been able to understand the rationale and respond at the chance level. Some have evaded detection by elaborations of the technique which seek evidence of non-randomness in the sequence of correct and incorrect responses. This paper reports the stratagem used by one such subject and a further elaboration of the technique by which it was detected.
Diagnoses made in a secondary care "fits, faints, and funny turns" clinic.
AIMS: To investigate the diagnoses made for children referred to a "fits, faints, and funny turns" clinic. METHODS: Prospective study of 380 children referred to a dedicated secondary care clinic over an eight year period. RESULTS: Twenty three per cent of children were given a final diagnosis of one of the childhood epilepsies, with 48% of these having a specific epilepsy syndrome. Syncope was the commonest cause of a non-epileptic event (syncope and reflex anoxic seizures comprised 100/238, 42%) but there were a wide variety of other causes. Fifty three events (14%) were unclassified and managed without a diagnostic label or treatment. CONCLUSIONS: In children with funny turns referred to secondary care, the diagnostic possibilities are numerous; among non-epileptic events, syncopes predominate. The majority do not have epilepsy. Unclassifiable events with no clear epileptic or non-epileptic cause are common and can be safely managed expectantly.
Mothering to death.
Three families are described in which the healthy only child was, from early childhood, put to bed and treated as if ill, dependent, and incapable. This abnormal mothering continued for 28, 45, and 48 years, respectively, and the children died as disabled adults. In each case, the three mothers evaded medical, educational, and social services. The origins of their behaviour are examined, and the links with more common forms of separation anxiety, school refusal, and perceived and factitious illness are discussed.
A unique case of auto-immune erythrocyte sensitization.
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C-peptide suppression test and sulphonylurea-induced factitious hypoglycaemia.
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Long term follow-up of factitious anaemia.
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Chronic multiple functional somatic symptoms.
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Hospital hoppers--jumping to conclusion?
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Factitious buccal lesion secondary to bruxism in a child with cerebral palsy.
Children with cerebral palsy are at greater risk of a whole range of oral conditions than their peers. These include bruxism (tooth grinding), oral skill dysfunction, gross malocclusion due to effects of the abnormal orofacial muscle tone on tooth eruption, drooling of saliva, and poor oral hygiene. A challenging case of a painful buccal lesion in a 2 year old girl with cerebral palsy (CP) that did not respond to antifungal, antiviral or antibiotic treatment is presented as a factitious lesion. The recognition and significance of self-injurious behaviour and factitious lesions in children are discussed.
Guidelines for the investigation of chronic diarrhoea, 2nd edition.
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Functional symptoms in neurology: management.
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