The cause of polydipsia is complex and still inconclusive in the medical community, but it tends to be caused not by a single cause but by multiple causes, probably as a result of the interaction of genetic and non-genetic factors (biological, psychological and environmental) during development. It is one of the neuropsychiatric disorders that occur in children.
Twitching symptoms include motor and vocal twitches, which can occur sequentially or simultaneously. Ocular twitching is often the first symptom. Blinking is considered to be the most common first symptom of tic disorder. The twitching episodes are clearly conscious and can be self-controlled for a short period of time, disappearing or alleviating after falling asleep, and can be aggravated or recurring with colds, diarrhea, fatigue, mental stress or prolonged television viewing. There is an alternating process of exacerbation and remission.
Motor tics: are sudden, rapid, purposeless, involuntary, and repetitive muscle twitches. The motor twitches usually start on the head and face, and the symptoms are mild, and then gradually worsen, involving the head and face, neck, shoulders, upper extremities, trunk and lower extremities in the order of development, and the site can be a single site or multiple sites. Facial muscle twitching is mostly manifested as blinking, squinting, raising eyebrows, frowning, grinning, shrugging nose, making strange and so on; head and neck muscle twitching is manifested as nodding, shaking head, jerking neck, shrugging shoulders, etc.; trunk muscle twitching is manifested as jerking chest, twisting waist, abdominal muscle twitching; upper limb twitching is manifested as rubbing fingers, clenching fist, shaking hands, raising arms, twisting arms; lower limb twitching is manifested as shaking legs, kicking legs, tiptoeing and even abnormal gait. Motor twitches are further divided into simple motor twitches and complex motor twitches. Simple motor twitches are sudden, brief, repetitive purposeless movements, usually involving one or several smaller muscle groups, are fulminant, short-lived, include multiple muscle groups, and can last for a longer period of time. The twitching may be complete or slow, and may appear to be purposeful, such as eye rolling, facial twitching with a particular expression, or a certain posture of the shoulders, arms, or hands and feet. For example, sudden reaching out to slap people, touching furniture, hitting one’s own body or dystonic postures such as spinning, jumping, bending or stooping, or sucking in the abdomen, which are often misunderstood and disgusted by people around.
Vocal tics: Vocal tics are also divided into simple vocal tics and complex vocal tics. Simple vocal twitching is characterized by rapid and meaningless monotonous repetition, such as constant throat clearing, coughing, humming, roaring, uttering, screaming, etc.; complex vocal twitching is characterized by meaningful phrases or more complex sentences, and also by repetitive and stereotyped complete statements, such as certain speech sounds, imitation speech, and repetitive speech, but the majority of cases of obscene speech are in adults, and the majority of cases are in children. However, obscene speech is more common in adults and less common in children. Vocal tics are generally characterized by slurred speech, nasal and delayed speech, and uneven strength and weakness of tones. Most patients present with motor tics first and vocal tics later; there are also some cases with motor and vocal tics at the same time.
Diagnostic criteria.
(1) Onset before the age of 18 years.
(2) Multiple motor twitches and one or more vocal twitches, mostly complex twitches, both of which are present at the same time.
(3) The twitches occur almost daily, multiple times a day, have lasted for at least 1 year or occur intermittently, and the symptoms do not remit for more than 2 months in 1 year.
(4) The twitching can be controlled by the will for a short period of time, intensify under stress, and disappear during sleep.
(5) The disorder causes significant impairment in daily life and social functioning, and the child is in great pain and distress.
(6) Involuntary twitching and vocalizations that cannot be explained by other disorders.
Numerous studies have concluded that the rate of EEG abnormalities in polydactyly is 12-75%. Background activity may be normal or mildly nonspecific abnormal, such as slow basic rhythms or increased theta waves, especially excessive theta activity in the frontal-central region. The rate of occurrence of evoked test epileptic discharges is 8.8%.
The main features of hyperactivity syndrome in children are short attention span and distractibility with excessive movements. It is also known as mild brain dysfunction or attention deficit disorder . The child has normal or basically normal intelligence, but has deficits in learning and behavior and temperament, manifested as inability to sit still, many small movements (also can be manifested as frequent blinking, shrugging, nodding, shaking head, etc.), and uncoordinated movements, difficulties in fine movements such as threading needles, buttoning, etc., inattentiveness and emotional impulsiveness.
Diagnostic criteria.
(A) Onset before the age of 7 years.
(B) The duration of the disease is more than 6 months.
(C) No mental retardation.
(iv) Presence of at least 8 of the following behaviors.
(1) The hands or feet often move incessantly or twist in a seated position.
(2) Difficulty sitting still when asked to do so.
3. Easily distracted by external stimuli.
4.Can’t wait patiently for a turn in a game or group activity.
5.Often rush to answer before others finish asking questions.
6.Difficulty in completing something as prompted by others (not due to disobedience or failure to understand), such as not finishing household chores.
7. Difficulty in maintaining attention during homework or games.
8. Often does not finish one thing and changes to another.
9.Hard to play quietly.
10.Often talk too much.
11.Often interrupts or interferes with others’ activities, such as interfering with other children’s play.
12.Often seems to listen when others speak to him.
13.Often loses objects used for learning and activities at school or at home (e.g., books, pencils, workbooks, toys, etc.).
14. Often participates in activities that are dangerous to the body without considering the possible consequences (not for thrill seeking), such as running to the center of the street without looking around.
(E) Physical and laboratory examination without specific positive signs or pathological reflexes. Sometimes the movements are clumsy and slow, and fine movements (such as buttoning and tying shoelaces) are slightly difficult. The intelligence examination is generally normal, and the EEG has no special abnormalities.
(F) Severity criteria of hyperactivity syndrome in children
1.Mild The number of symptoms does not (or slightly) exceed the number required for diagnosis, and the learning and social skills are not impaired or minimally impaired.
2.Moderate The symptoms or functional impairment is between mild and severe.
3.Severe The number of symptoms exceeds the number needed to make a diagnosis by a large margin. There is also significant and widespread impairment in family activities, school activities, and the ability to interact with other children.
The most common abnormality on the EEG in children with hyperactivity syndrome is background diffuse or intermittent slow wave activity beyond the normal range for that age, seen in 30-60% of children with ADHD, and this background activity abnormality mostly disappears with age.
Epilepsy is often called “sheep epilepsy” or “piggyback wind” in folklore. It is a paroxysmal transient brain disorder characterized by recurrent episodes of generalized or localized muscle spasms, with or without impaired consciousness, and also with abnormal sensory, behavioral, emotional, and autonomic functions. The onset of the disease is mainly associated with.
1, genetic factors.
2. The primary causes of secondary epilepsy are.
① organic lesions of the brain such as dysplasia, degenerative lesions, various intracranial sensations, traumatic brain injury, cerebral thrombotic lesions, birth injuries;
②Brain injury due to various causes;
③Metabolic disorders;
④ poisoning. Epilepsy is a chronic brain disease with ion channel abnormalities, which may lead to seizures as long as there is some factor that excites the patient’s brain cells to discharge, and is particularly prone to recurrence and requires long-term treatment.
The diagnosis of having a typical seizure is not difficult. However, seizures with bizarre behavior and posture are often misdiagnosed as pseudoseizures or other seizure motor disorders, and, in some parts of the seizure, the interictal and ictal EEGs are often normal, or the absence of specific abnormalities can increase the incidence of misdiagnosis. However, by recognizing the sudden onset and termination of seizures and the stereotypical and brief presentation, misdiagnosis can be reduced to some extent.