A Rare Presentation of Attention Defcit/Hyperactivity Disorder A recommendation to be more alert!
Journal Title: Sultan Qaboos University Medical Journal - Year 2010, Vol 10, Issue 1
Abstract
We report the case of a 7 year-old Omani girl with tuberous sclerosis (TS), attention defcit hyperactivity disorder (ADHD) and bipolar disorder (BD), at Sultan Qaboos University Hospital (SQUH), Oman. For a year she had been suffering from hyperactivity, aggression, over talkativeness, insomnia, risk-taking behaviour, distractibility, poor attention and seizures. Tis clinical picture evolved slowly, but was progressive in nature. Before the consultation at her local health centre, she was given four drugs without being properly investigated; she continued to deteriorate. In SQUH, she showed hyperactive-impulsive behaviour, elation, flight of ideas, preoccupation with self and high self-confdence. Te physical examination revealed multiple hypomelanotic patches all over the body and a shagreen patch at the sacral area. Te electroencephalogram showed generalised epileptic discharges, while brain imaging showed multiple parenchymal calcifed foci in both cerebral hemispheres. Other investigations were normal. She was given valproate, and then a psychostimulant, methylphenidate, that controlled her state. Our aim in reporting this case is not only because it is unique, given its rare comorbidity (ADHD, TS and BD), but also to remind our junior colleagues to be alert to the possibility of an underlying neuropathology when performing clinical examinations and investigations of children presenting with neuropsychiatric symptoms.
Authors and Affiliations
Marwan Al-Sharbati| Departments of Behavioral Medicine, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman, Rashid Al-Zaidi| Departments of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Rahma Al-Naamani| Departments of Behavioral Medicine, Sultan Qaboos University Hospital, Muscat, Oman, Amna Al-Futaisi| Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Rajeev Jain| Departments of Radiology College of Medicine and Health Sciences, Sultan Qaboos University, Muscat
Keywords
Related Articles
- EP ID EP13922
- DOI -
- Views 326
- Downloads 12
GlideScope® for Assessment of Recurrent Laryngeal Nerve Integrity after Thyroid Surgery
Magnetic Resonance Imaging Abnormalities in a Child with Acute Cerebellitis
The Concept of Somatisation A Cross-cultural perspective
Somatisation is generally defned as the tendency to experience psychological distress in the form of somatic symptoms and to seek medical help for these symptoms, which may be initiated and/or perpetuated by emotional...
Osteosarcoma of the Proximal Femur Mimicking Septic Arthritis of the Hip: A diagnostic dilemma
Septic arthritis is a surgical emergency requiring prompt drainage of the accumulation of pus in the joint. We report an eight-year-old boy who was referred to the Armed Forces Hospital, Salalah, Oman, in 2016 with limpi...
Coronary Arteries Ectasia