Child and adolescent psychiatric clinics of North America
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Child Adolesc Psychiatr Clin N Am · Oct 1999
ReviewTraumatic brain injury in children and adolescents.
Traumatic brain injury is an insult to the brain caused by an external force that results in an impairment (transient or permanent) of cognitive, behavioral, emotional, or physical function. Traumatic brain injury encompasses shearing injury, which might be seen in a shaken infant, as well as penetrating injury from a foreign body, such as a bullet. This article addresses the recovery phase and functional sequelae following traumatic brain injury. Research and clinical experience over the past decade have led to a better understanding of the pathophysiology of head injury and, in turn, improved management.
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Child Adolesc Psychiatr Clin N Am · Oct 1999
ReviewImmune mechanisms in pediatric neuropsychiatric disorders. Tourette's syndrome, OCD, and PANDAS.
The authors have reviewed recent data supporting the presence of immune abnormalities in several neuropsychiatric disorders (TS, OCD, and PANDAS). Several groups agree that there is a subset of patients with TS and OCD (perhaps about 10%) for whom there is a clear streptococcal trigger, validating the PANDAS concept. ⋯ If this line of research reveals definable, and relatively specific, immune abnormalities in at least some cases of TS and OCD, it will likely have important implications for the diagnosis and treatment of these common neuropsychiatric disorders, particularly in children who respond poorly to conventional therapies. Child psychiatrists are encouraged to stay tuned.
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Headache is common in children and adolescents. A thorough history, examination, and a neurologic evaluation with charting of the temporal pattern of the headache and evaluation of psychosocial factors will allow the correct diagnosis to be made. ⋯ Psychological factors are important in all forms of headache and should be evaluated in each and every case. A comprehensive approach to the patient's problem, including medical and psychological interventions, will usually result in improvement.