Objectives: Functional neurological disorders (FNDs) are a common source of disability in medicine. Patients have often been misdiagnosed, correctly diagnosed after long delays, and/or subjected to misdiagnoses that lead to inadequate treatments, unnecessary costly evaluations, and poor outcomes. We sought to identify the epidemiological and clinical characteristics of children and adolescents suffering from functional neurological disorders in the child and adolescent psychiatry department in CASABLANCA. Methods: We conducted a retrospective study of 52 children and adolescents admitted for functional neurological disorders from March 2019 to July 2021, and analyzed their clinical profiles, sociocultural, environmental and psychological characteristics. Results: In our study, nearly the threatening quarters of the patients were girls, stressor antecedents were notably reported, most often related to family stressors. Recent or distant history of abuse was of varying degrees. The neurological presentations were complex, with nearly half of the patients having multiple distinct neurological symptoms. Motor symptoms and non-epileptic seizures were the most frequent, with an acute mode of onset in the majority of the cases. The course was marked by the regression of symptoms in the majority of patients, with their persistence in the third of the cases, meanwhile a small group of the cases interrupted the follow-up. A high resource use was noted due to the participation of several specialized consultants, the conduction of many diagnostic studies, and lengthy hospital stays. Conclusion: Our data confirms previous findings in the literature and contributes to a better understanding and characterization of our population.
We here report the case of a 6-year old female patient with no pathological history, presenting with diffuse abdominal pain and abdominal distension evolving in the last 2 months. The patient had a deterioration in her general condition. Clinical examination showed distended abdomen, average abundance ascites, venous collateral circulation and multiple mobile hard abdominal masses measuring 3-4 cm in diameter at the level of the iliac fossa and of the left hypochondriac region associated with a well circumscribed, hard, rounded umbilical mass measuring 3cm in diameter lifting the skin with inflammatory signs (A). The remainder of the physical examination was normal. Thoraco-abdominal CT scan showed subcutaneous umbilical nodule (B), with homogeneous enhancement measuring 36x29x19mm, associated with mesenteric lymphadenopathy magmas, pelvic mass and extended jejunum thickening. Fine needle aspiration biopsy of the mass showed the presence of several naked nuclei and a few blasts. Biopsy showed Burkitt lymphoma. Therefore, the diagnosis of Burkitt lymphoma revealed by sister Marie-Josèphe nodule was retained and the patient underwent chemotherapy according the LMB01 protocol. Outcome was favorable, marked by the regression of the nodule and of the abdominal masses. Sister Mary Joseph nodule is an umbilical metastasis from a tumor (usually an abdomino pelvic tumor) mainly an adenocarcinoma, exceptionally a lymphoma. It is a rare sign. It accounts for 1-3% of all abdomino-pelvic neoplasms and it is associated with poor prognosis. It is essential to know that this nodule is a lesion secondary to solid tumor in order to avoid delayed management of the underlying neoplasm.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.