Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
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Case Reports
[Reversible cerebral vasoconstriction syndrome: A rare pediatric cause of thunderclap headaches].
Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by thunderclap headaches with diffuse segmental constriction of cerebral arteries that resolves spontaneously within 3 months. We report on a case of a 13-year-old boy presenting with acute severe headaches, triggered by physical exertion. His past medical history was uneventful. ⋯ In most patients, the RCVS symptoms resolve spontaneously within days or weeks. Ischemic and hemorrhagic stroke are the major complications of the syndrome. A diagnosis of RCVS can only be confirmed when the reversibility of the vasoconstriction is assessed.
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Postinfectious erythema multiforme is an uncommon skin disease in childhood that can have a strong impact, especially in infants if there is involvement of the mucous membranes. The lesion is targeted (central bullous lesions with three concentric circles). Its diagnosis is typically made clinically. ⋯ More recently, postvaccination erythema multiforme has been reported with the majority of vaccines used in pediatric practice. The prognosis is usually good but requires observation of the mucosal involvement because of the risk of serious complications. The treatment of erythema multiforme is essentially symptomatic, with etiology-related treatment.
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Chronic pain in children and adolescents has a major impact on their life in terms of school, sleep as well as family and social life. Teenagers aged 13-15 and girls are at the highest risk. Zeltzer et al. established a bio-psychosocial model of chronic pain in 1998 to account for all its dimensions and advocated a multidisciplinary management plan. Programs based on their principles target specific symptoms such as anxiety and loss of function, while treating underlying factors and teaching coping skills to patients and their families. They aim for patients to regain autonomy rather than focusing on pain resolution. Such programs, with varied protocols, have existed outside of France for approximately 15 years. The efficacy of these multidisciplinary programs has been shown in studies in Germany, the United Kingdom, the United States, Canada, and Australia. To our knowledge, there are no French studies on this topic; therefore, our aim was to describe a French program. We hypothesized that the program would be effective in reducing chronic pain and its impact. ⋯ The multidisciplinary pain management program in this French pediatric functional rehabilitation center shows results comparable to the programs described in other countries. Chronic pain should be evaluated with standardized and validated tools, such as the measurement of the pain-related disability with the Functional Disability Index.
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Cannabis is the most widely used illicit drug in the world. In France, cannabis use has been increasing among youth since 2011, in both experimental use and regular consumption. A distinct syndrome, characterized by recurrent vomiting associated with abdominal pain and compulsive bathing, has been increasingly recognized in adult chronic users. ⋯ To date, the specific etiology of CHS is unknown as is the pathophysiology of improvement with hot baths. All youth presenting with cyclic vomiting should be questioned about cannabis use and compulsive hot bathing. The early recognition of this syndrome will save unnecessary and invasive investigations.