Tetanus differential diagnosis: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
No edit summary
Line 174: Line 174:


{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 83%;"
{| style="border: 2px solid #DCDCDC; font-size: 90%; width: 83%;"
|+ '''Differential Diagnosis on the basis of Rigidity and Fever'''
|+ '''Differential Diagnosis of Tetanus'''
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Disease
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
! colspan="3" align="center" style="background:#4479BA; color: #FFFFFF;" |Diagnosis
Line 183: Line 183:
! align="center" style="background:#4479BA; color: #FFFFFF;" |Laboratory Findings
! align="center" style="background:#4479BA; color: #FFFFFF;" |Laboratory Findings
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Tetanus]]<ref name="pmid27538652">{{cite journal| author=Woldeamanuel YW, Andemeskel AT, Kyei K, Woldeamanuel MW, Woldeamanuel W| title=Case fatality of adult tetanus in Africa: Systematic review and meta-analysis. | journal=J Neurol Sci | year= 2016 | volume= 368 | issue=  | pages= 292-9 | pmid=27538652 | doi=10.1016/j.jns.2016.07.025 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27538652  }} </ref><ref name="pmid26598719">{{cite journal| author=Thwaites CL, Loan HT| title=Eradication of tetanus. | journal=Br Med Bull | year= 2015 | volume= 116 | issue=  | pages= 69-77 | pmid=26598719 | doi=10.1093/bmb/ldv044 | pmc=4674006 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26598719  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Tetanus]]  
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
*Tonic contraction of muscles between the spasmodic episodes
*Tonic contraction of muscles between the spasmodic episodes
Line 202: Line 202:
* Human TIG
* Human TIG
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Neuroleptic malignant syndrome|Neuroleptic Malignant Syndrome]] <ref name="pmid28533580">{{cite journal| author=Hosseini S, Elyasi F| title=Olanzapine-Induced Neuroleptic Malignant Syndrome. | journal=Iran J Med Sci | year= 2017 | volume= 42 | issue= 3 | pages= 306-309 | pmid=28533580 | doi= | pmc=5429500 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28533580  }} </ref><ref name="pmid28488314">{{cite journal| author=Leenhardt F, Perier D, Pinzani V, Giraud I, Villiet M, Castet-Nicolas A et al.| title=Pharmacist intervention to detect drug adverse events on admission to the emergency department: Two case reports of neuroleptic malignant syndrome. | journal=J Clin Pharm Ther | year= 2017 | volume=  | issue=  | pages=  | pmid=28488314 | doi=10.1111/jcpt.12531 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28488314  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Neuroleptic malignant syndrome|Neuroleptic Malignant Syndrome]]  
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
*History of intake of offending drugs e.g [[neuroleptics]] like:
*History of intake of offending drugs e.g [[neuroleptics]] like:
**[[Fluphenazine]]  
**[[Fluphenazine]]  
**[[Haloperidol]]
**[[Haloperidol]]
**[[Olanzapine]]
**[[Risperidone]]
**[[Risperidone]]
*[[Autonomic instability]]
*[[Autonomic instability]]
Line 220: Line 219:
* [[Agitation]]
* [[Agitation]]
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
** [[Myoglobinemia]]
* [[Myoglobinemia]]
** Elevated [[LDH]]
* Elevated [[LDH]]
** Elevated [[creatine kinase]]  
* Elevated [[creatine kinase]]  
** [[Hyperkalemia]]
* [[Hyperkalemia]]
** Elevated [[AST]] and [[ALT]]
* Elevated [[AST]] and [[ALT]]
** [[Hyperphosphatemia]]
* [[Hyperphosphatemia]]
** Elevated [[alkaline phosphatase]]
* Elevated [[alkaline phosphatase]]
** [[Hyperuricemia]]
* [[Hyperuricemia]]
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Supportive therapy
* Supportive therapy
Line 236: Line 235:
** [[Bromocriptine]]
** [[Bromocriptine]]
|-
|-
| style="background: #F5F5F5; padding: 5px;" | [[Meningitis|Viral Meningitis]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618  }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096 }} </ref><ref name="pmid15319091">{{cite journal| author=Tyler KL| title=Herpes simplex virus infections of the central nervous system: encephalitis and meningitis, including Mollaret's. | journal=Herpes | year= 2004 | volume= 11 Suppl 2 | issue=  | pages= 57A-64A | pmid=15319091 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=15319091 }} </ref>
| style="background: #F5F5F5; padding: 5px;" | [[Meningitis|Viral Meningitis]]<ref name="pmid24326618">{{cite journal| author=Chow E, Troy SB| title=The differential diagnosis of hypoglycorrhachia in adult patients. | journal=Am J Med Sci | year= 2014 | volume= 348 | issue= 3 | pages= 186-90 | pmid=24326618 | doi=10.1097/MAJ.0000000000000217 | pmc=4065645 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24326618  }} </ref><ref name="pmid22880096">{{cite journal| author=Leen WG, Willemsen MA, Wevers RA, Verbeek MM| title=Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice. | journal=PLoS One | year= 2012 | volume= 7 | issue= 8 | pages= e42745 | pmid=22880096 | doi=10.1371/journal.pone.0042745 | pmc=3412827 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22880096  }} </ref>
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* [[Fever]]
* [[Fever]]
Line 274: Line 273:
** [[Acetaminophen]] for [[fever]].
** [[Acetaminophen]] for [[fever]].
* Anti-viral therapy:
* Anti-viral therapy:
** [[Acyclovir]]
** [[Acyclovir]] <sup>[[Viral meningitis medical therapy#cite note-pmid15319091-2|[2]]]</sup>
** [[Pleconaril]]
** [[Pleconaril]]
|-
|-
Line 308: Line 307:
* [[Prednisone]], [[plasmapheresis]], [[IVIG]] ( some success)
* [[Prednisone]], [[plasmapheresis]], [[IVIG]] ( some success)
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Drug]] induced  [[Tardive dyskinesia|(Tardive dyskinesia]])<ref name="pmid28552340">{{cite journal| author=Deng ZD, Li DY, Zhang CC, Pan YX, Zhang J, Jin H et al.| title=Long-term follow-up of bilateral subthalamic deep brain stimulation for refractory tardive dystonia. | journal=Parkinsonism Relat Disord | year= 2017 | volume=  | issue=  | pages=  | pmid=28552340 | doi=10.1016/j.parkreldis.2017.05.010 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28552340  }} </ref><ref name="pmid28520698">{{cite journal| author=| title=Valbenazine (Ingrezza) for tardive dyskinesia. | journal=Med Lett Drugs Ther | year= 2017 | volume= 59 | issue= 1521 | pages= 83-84 | pmid=28520698 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28520698  }} </ref><ref name="pmid28510661">{{cite journal| author=Voelker R| title=Tardive Dyskinesia Drug Approved. | journal=JAMA | year= 2017 | volume= 317 | issue= 19 | pages= 1942 | pmid=28510661 | doi=10.1001/jama.2017.5537 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28510661  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Drug]] induced  [[Tardive dyskinesia|(Tardive dyskinesia]])
| style="background: #DCDCDC; padding: 5px;" |  
| style="background: #DCDCDC; padding: 5px;" |  
*History of intake of the offending drug for at least one month
*History of intake of the offending drug for at least one month
Line 381: Line 380:
**''Strychnos nux vomica seeds''
**''Strychnos nux vomica seeds''
**Rodenticide
**Rodenticide
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  
* Hypervigilance
* Anxiety
* Mydriasis
* Hypereflexia
* Clonus
* Facial and neck stiffness
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Blood assay
* Blood assay
Line 393: Line 386:
* Urine assay
* Urine assay
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Initial stabilization
* High dose [[Benzodiazepines]]
* Intubation and airway securing
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Hypocalcaemia]]<ref name="pmid27065735">{{cite journal| author=Chhabra P, Rana SS, Sharma V, Sharma R, Bhasin DK| title=Hypocalcemic tetany: a simple bedside marker of poor outcome in acute pancreatitis. | journal=Ann Gastroenterol | year= 2016 | volume= 29 | issue= 2 | pages= 214-20 | pmid=27065735 | doi=10.20524/aog.2016.0015 | pmc=4805743 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27065735  }} </ref><ref name="pmid24171002">{{cite journal| author=Desai M, Kolla PK, Reddy PL| title=Calcium unresponsive hypocalcemic tetany: gitelman syndrome with hypocalcemia. | journal=Case Rep Med | year= 2013 | volume= 2013 | issue=  | pages= 197374 | pmid=24171002 | doi=10.1155/2013/197374 | pmc=3792521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24171002  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Hypocalcaemia]]
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
*[[Muscle]] [[twitching]] and [[cramping]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  
*Circumoral and extremity [[paresthesia]] or [[tingling]]
* [[Altered mental status]]
* [[Irritability]]
* [[Depression]]
* [[Psychosis]]
* [[Seizure]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
** [[Tetany (medical sign)|Tetany]] (carpopedal spasm)
** Latent tetany
*** [[Trousseau sign of latent tetany]] 
*** [[Chvostek's sign]] 
** Hyperactive tendon reflexes
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Decreased blood [[calcium]] levels
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Two [[Ampule|ampules]] of [[intravenous]] [[calcium gluconate]] 10% is given slowly in a period of 10 minutes, or
* If hypocalcemia is severe, [[calcium chloride]] is given instead
* Maintenance doses of both calcium and [[vitamin-D]]
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Dental abscess]]<ref name="pmid28317564">{{cite journal| author=Ogle OE| title=Odontogenic Infections. | journal=Dent Clin North Am | year= 2017 | volume= 61 | issue= 2 | pages= 235-252 | pmid=28317564 | doi=10.1016/j.cden.2016.11.004 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28317564  }} </ref><ref name="pmid27930461">{{cite journal| author=Bertossi D, Barone A, Iurlaro A, Marconcini S, De Santis D, Finotti M et al.| title=Odontogenic Orofacial Infections. | journal=J Craniofac Surg | year= 2017 | volume= 28 | issue= 1 | pages= 197-202 | pmid=27930461 | doi=10.1097/SCS.0000000000003250 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27930461  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Dental abscess]]
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Tooth pain
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  
* Painful eating and chewing
* [[Fever]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
* Poor oral hygiene
* Presence of a dental infection
* Swollen gums
* No progression of spasm with time
* Cheek swelling
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Clinical diagnosis
* Labs may include
** Microscopic exam of stained smear
** Culture of oral swab
** Blood culture
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Improved dental hygiene
** Use of fluoridated water
** Brushing regularly
* [[Antibiotics]]
* Dental extraction in case of severity
|-
|-
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Parkinson's disease]]<ref name="pmid11402154">{{cite journal| author=Olanow CW, Watts RL, Koller WC| title=An algorithm (decision tree) for the management of Parkinson's disease (2001): treatment guidelines. | journal=Neurology | year= 2001 | volume= 56 | issue= 11 Suppl 5 | pages= S1-S88 | pmid=11402154 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11402154  }} </ref><ref name="pmid24756517">{{cite journal| author=Connolly BS, Lang AE| title=Pharmacological treatment of Parkinson disease: a review. | journal=JAMA | year= 2014 | volume= 311 | issue= 16 | pages= 1670-83 | pmid=24756517 | doi=10.1001/jama.2014.3654 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24756517  }} </ref>
| style="background: #F5F5F5; padding: 5px; text-align: center;" | [[Parkinson's disease]]
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* [[Stiffness]]
| style="background: #F5F5F5; padding: 5px; text-align: center;" |  
* Inability to write
* Jerky movements at rest
* [[Constipation]]
* Sleeping difficulty
* Walking difficulty
| style="background: #F5F5F5; padding: 5px; text-align: center;" |
* [[Tremor]]
* Rigidity
* [[Bradykinesia]]
* [[Postural instability]]
* Shuffling gait
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Clinical diagnosis
* Improvement with dopaminergic therapy confirms diagnosis
| style="background: #DCDCDC; padding: 5px;" |
| style="background: #DCDCDC; padding: 5px;" |
* Symptomatic therapy
* [[Dopamine agonists]]
* [[Levodopa]]
* [[Amantadine]]
* [[MAO inhibitors]]
* COMT inhibitors
* [[Anticholinergics]]
|}
|}


Revision as of 21:13, 12 June 2017

Tetanus Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tetanus from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Xray

CT scan

MRI

Ultrasound

Other Imaging Studies

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tetanus differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tetanus differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Tetanus differential diagnosis

CDC on Tetanus differential diagnosis

Tetanus differential diagnosis in the news

Blogs on Tetanus differential diagnosis

Directions to Hospitals Treating Tetanus

Risk calculators and risk factors for Tetanus differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Michael Maddaleni, B.S.; Associate Editor(s)-in-Chief: Usama Talib, BSc, MD [2]

Overview

Tetanus must be differentiated from strychnine poisoning, dental infections, drug reactions, hypocalcemia, meningitis, stroke and stiff man syndrome.[1]

Differentiating Tetanus from other Diseases

Some of the other diseases that need to be considered when trying to diagnose tetanus include:[2][3][4]

Differential for Unilateral Involuntary Face Movements

The differential diagnosis for abnormal one sided movements of the face includes:[5][6][7][8][9][10][11][12][13][14][15]

Differential Diagnosis of Tetanus
Disease Diagnosis Treatment
Symptoms Signs Laboratory Findings
Tetanus
  • Not significant
Neuroleptic Malignant Syndrome
Viral Meningitis[16][17]
Stiff man syndrome
  • Marked rigidity
  • Spasms
    • Intermittent
    • Painful
    • Absent during sleep
Drug induced (Tardive dyskinesia)
  • History of intake of the offending drug for at least one month
  • Eye deviation
  • Head and neck jerky movements
  • No tonic contraction of the muscles between the spasms
Strychnine poisoning[18][19][20][21]
  • Hx of up to date tetanus immunizations
  • History of intentional or accidental intake
    • Strychnos nux vomica seeds
    • Rodenticide
  • Blood assay
  • Tissue assay
  • Urine assay
Hypocalcaemia
Dental abscess
Parkinson's disease

References

  1. ↑ Anisha Doshi, Clare Warrell, Dima Dahdaleh & Dimitri Kullmann (2014). "Just a graze? Cephalic tetanus presenting as a stroke mimic". Practical neurology. 14 (1): 39–41. doi:10.1136/practneurol-2013-000541. PMID 24052566. Unknown parameter |month= ignored (help)
  2. ↑ E. Andreadou, E. Kattoulas, C. Sfagos & D. Vassilopoulos (2007). "Stiff person syndrome: avoiding misdiagnosis". Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 28 (1): 35–37. doi:10.1007/s10072-007-0745-9. PMID 17385093. Unknown parameter |month= ignored (help)
  3. ↑ Lisa Mitchell, William Adams & Francois Aspesberro (2017). "Case 6: Episodic Stiffness in a 30-month-old Girl". Pediatrics in review. 38 (1): 52–53. doi:10.1542/pir.2014-0142. PMID 28044038. Unknown parameter |month= ignored (help)
  4. ↑ P. D. Thompson, J. A. Obeso, G. Delgado, J. Gallego & C. D. Marsden (1986). "Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm". Journal of neurology, neurosurgery, and psychiatry. 49 (6): 651–656. PMID 3734821. Unknown parameter |month= ignored (help)
  5. ↑ P. D. Thompson, J. A. Obeso, G. Delgado, J. Gallego & C. D. Marsden (1986). "Focal dystonia of the jaw and the differential diagnosis of unilateral jaw and masticatory spasm". Journal of neurology, neurosurgery, and psychiatry. 49 (6): 651–656. PMID 3734821. Unknown parameter |month= ignored (help)
  6. ↑ J. R. Berger, W. A. Sheremata & E. Melamed (1984). "Paroxysmal dystonia as the initial manifestation of multiple sclerosis". Archives of neurology. 41 (7): 747–750. PMID 6743065. Unknown parameter |month= ignored (help)
  7. ↑ W. B. Matthews (1975). "Paroxysmal symptoms in multiple sclerosis". Journal of neurology, neurosurgery, and psychiatry. 38 (6): 617–623. PMID 1151430. Unknown parameter |month= ignored (help)
  8. ↑ P. D. Thompson & W. M. Carroll (1983). "Hemimasticatory spasm--a peripheral paroxysmal cranial neuropathy?". Journal of neurology, neurosurgery, and psychiatry. 46 (3): 274–276. PMID 6842234. Unknown parameter |month= ignored (help)
  9. ↑ P. D. Thompson & W. M. Carroll (1983). "Hemimasticatory and hemifacial spasm: a common pathophysiology?". Clinical and experimental neurology. 19: 110–119. PMID 6568919.
  10. ↑ L. R. Jenkyn, D. B. Walsh, C. M. Culver & A. G. Reeves (1977). "Clinical signs in diffuse cerebral dysfunction". Journal of neurology, neurosurgery, and psychiatry. 40 (10): 956–966. PMID 591973. Unknown parameter |month= ignored (help)
  11. ↑ J. D. Rugh & W. K. Solberg (1976). "Psychological implications in temporomandibular pain and dysfunction". Oral sciences reviews. 7: 3–30. PMID 775369.
  12. ↑ Bond WS (1984). "Detection and management of the neuroleptic malignant syndrome". Clin Pharm. 3 (3): 302–7. PMID 6145537.
  13. ↑ S. Fahn, S. B. Bressman & C. D. Marsden (1998). "Classification of dystonia". Advances in neurology. 78: 1–10. PMID 9750897.
  14. ↑ Howard L. Geyer & Susan B. Bressman (2006). "The diagnosis of dystonia". The Lancet. Neurology. 5 (9): 780–790. doi:10.1016/S1474-4422(06)70547-6. PMID 16914406. Unknown parameter |month= ignored (help)
  15. ↑ Christine Klein & Laurie J. Ozelius (2002). "Dystonia: clinical features, genetics, and treatment". Current opinion in neurology. 15 (4): 491–497. PMID 12151848. Unknown parameter |month= ignored (help)
  16. ↑ Chow E, Troy SB (2014). "The differential diagnosis of hypoglycorrhachia in adult patients". Am J Med Sci. 348 (3): 186–90. doi:10.1097/MAJ.0000000000000217. PMC 4065645. PMID 24326618.
  17. ↑ Leen WG, Willemsen MA, Wevers RA, Verbeek MM (2012). "Cerebrospinal fluid glucose and lactate: age-specific reference values and implications for clinical practice". PLoS One. 7 (8): e42745. doi:10.1371/journal.pone.0042745. PMC 3412827. PMID 22880096.
  18. ↑ Charlotte Duverneuil, Geoffroy Lorin de la Grandmaison, Philippe de Mazancourt & Jean-Claude Alvarez (2004). "Liquid chromatography/photodiode array detection for determination of strychnine in blood: a fatal case report". Forensic science international. 141 (1): 17–21. doi:10.1016/j.forsciint.2003.12.010. PMID 15066709. Unknown parameter |month= ignored (help)
  19. ↑ B. A. Smith (1990). "Strychnine poisoning". The Journal of emergency medicine. 8 (3): 321–325. PMID 2197324. Unknown parameter |month= ignored (help)
  20. ↑ B. J. Maron, J. R. Krupp & B. Tune (1971). "Strychnine poisoning successfully treated with diazepam". The Journal of pediatrics. 78 (4): 697–699. PMID 5547830. Unknown parameter |month= ignored (help)
  21. ↑ B. Oberpaur, A. Donoso, C. Claveria, C. Valverde & M. Azocar (1999). "Strychnine poisoning: an uncommon intoxication in children". Pediatric emergency care. 15 (4): 264–265. PMID 10460082. Unknown parameter |month= ignored (help)

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Tetanus_differential_diagnosis&oldid=1317053"