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Lethargy

Lethargic


Presentation

  • We present the case of a postictal patient with lethargy, hyperammonemia, otherwise normal liver function tests, and a therapeutic valproic acid level.[ncbi.nlm.nih.gov]
  • A case of intussusception in a 6 month old with lethargy as the initial and predominant system is presented.[ncbi.nlm.nih.gov]
  • The clinical presentation and management of a newborn whose mother received lithium during pregnancy is presented. The newborn manifested a four day course of lethargy with unexplained high lithium levels in the adult toxic range.[ncbi.nlm.nih.gov]
  • Four cardinal signs and symptoms (abdominal pain, rectal bleeding, vomiting, and abdominal mass) are described in patients with intussusception, but these manifestations are not always present and their absence may lead to misdiagnosis.[ncbi.nlm.nih.gov]
  • The second patient was diagnosed after presenting to the emergency department with intermittent lethargy, right lower quadrant abdominal tenderness, and heme-positive stool.[ncbi.nlm.nih.gov]
Sepsis
  • Delay in diagnosis and treatment may be associated with decreased success rates of reduction by barium enema, and increased rates of complications of perforation, peritonitis, sepsis, and death.[ncbi.nlm.nih.gov]
  • Intravenous ceftriaxone, vancomycin and acyclovir were immediately started for possible sepsis before blood and cerebrospinal fluid cultures were drawn.[ncbi.nlm.nih.gov]
Developmental Delay
  • A 16 year female with a history of developmental delay and shunted hydrocephalus presented with two months of progressive headaches, lethargy and visual disturbances.[ncbi.nlm.nih.gov]
Poor Feeding
  • METHODS: A retrospective chart review of patients aged 0 to 6 months with a chief complaint of lethargy or poor feeding from January 2004 to December 2009 was performed.[ncbi.nlm.nih.gov]
Intravenous Administration
  • Here, we show that intravenous administration of propionate causes dose-dependent propionate accumulation in the brain and transient lethargy in mice.[ncbi.nlm.nih.gov]
Hypothermia
  • Patients were excluded if they had a fever, hypothermia, a chronic medical condition, or a history of trauma. Charts were reviewed by a single investigator; 10% were reviewed by a second investigator for agreement.[ncbi.nlm.nih.gov]
Respiratory Distress
  • A premature male baby (28 weeks gestational age) was delivered by Cesarean section and required ventilation for respiratory distress syndrome during the first postnatal week.[ncbi.nlm.nih.gov]
  • A newborn boy was admitted to the hospital because of respiratory distress and hypotension. At delivery, meconium was suctioned from the airway. Respiration and blood pressure improved after intervention, but lethargy and myoclonus developed.[nejm.org]
  • ‘Symptoms include lethargy and disorientation, as well as life-threatening seizures and respiratory distress.’ ‘Symptoms include vomiting, lethargy and frequently coma.’[en.oxforddictionaries.com]
Abdominal Mass
  • The results indicate that lethargy is an important symptom in patients with intussusception when occurring in association with vomiting, melena, or a palpable abdominal mass, or all three.[ncbi.nlm.nih.gov]
  • Four cardinal signs and symptoms (abdominal pain, rectal bleeding, vomiting, and abdominal mass) are described in patients with intussusception, but these manifestations are not always present and their absence may lead to misdiagnosis.[ncbi.nlm.nih.gov]
  • No abdominal mass was palpable and bowel sounds were normal. Blood tests were unremarkable. An urgent ultrasound was performed for further assessment (fig 1 ).[bmj.com]
Melena
  • The results indicate that lethargy is an important symptom in patients with intussusception when occurring in association with vomiting, melena, or a palpable abdominal mass, or all three.[ncbi.nlm.nih.gov]
Abdominal Tenderness
  • The diagnosis of intussusception was made after he developed right lower quadrant abdominal tenderness and heme-positive stool.[ncbi.nlm.nih.gov]
Thrombosis
  • Autopsy showed bilateral thrombosis of the deep cerebral veins.[ncbi.nlm.nih.gov]
  • Seven neonates who presented with either lethargy (four infants) or seizures (three infants) were found by magnetic resonance (MR) phase imaging to have idiopathic cerebral venous thrombosis (CVT). Examination showed only hypotonia or hyperreflexia.[ncbi.nlm.nih.gov]
Torticollis
  • This 6-month-old Caucasian boy presented with a 10-day history of lethargy, obtundation, inability to hold his head up and mild torticollis.[ncbi.nlm.nih.gov]
Cesarean Section
  • A premature male baby (28 weeks gestational age) was delivered by Cesarean section and required ventilation for respiratory distress syndrome during the first postnatal week.[ncbi.nlm.nih.gov]
Dysuria
  • Autonomic dysfunction such as sleep apnea, orthostatic hypotension, dysuria, and hypohidrosis predominated with lethargy, whereas parkinsonism was not apparent.[ncbi.nlm.nih.gov]
Altered Mental Status
  • Based on our experience and on previously published data, serum ammonia levels appear to be indicated in all ED patients on valproic acid therapy who present with altered mental status.[ncbi.nlm.nih.gov]
  • Some children with intussusception may appear lethargic or have altered mental status, believed by physicians to be related to ischemia of the bowel and a decreased level of consciousness. Lana awoke lethargic and in pain.[yourdictionary.com]
Stupor
  • The Online Medical Dictionary describes lethargy as "Abnormal drowsiness or stupor, a condition of indifference." Lethargy is a very different condition than the quiet-but-alert behavior generally called "stationary alert" by ethologists.[anapsid.org]
  • Stupor is often produced by the effects of alcohol or narcotics; it suggests a benumbed or dazed state of mind: “The huge height of the buildings. .. the hubbub and endless stir. .. struck me into a kind of stupor of surprise” (Robert Louis Stevenson)[yourdictionary.com]
Neglect
  • He has not attended a morning lecture since he and Scrole consummated their physical relationship last month, and is in danger of failing two other classes for which he has neglected to hand in papers.[theonion.com]
  • Alex V Levin , MD MHSc FAAP FAAO FRCSC Suspected Child Abuse and Neglect (SCAN) Program, The Hospital for Sick Children; Departments of Paediatrics, Genetics and Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario Adam Rapoport[ncbi.nlm.nih.gov]
Hyperreflexia
  • Examination showed only hypotonia or hyperreflexia. The presence of CVT was suggested by unenhanced cranial computed tomographic (CT) scans.[ncbi.nlm.nih.gov]
Neonatal Seizures
  • The occurrence of seven infants with idiopathic neonatal CVT within a 3-month period indicates that CVT may be a cause of neonatal seizures or lethargy of unclear cause.[ncbi.nlm.nih.gov]

Workup

  • Cerebrospinal fluid (CSF) samples are frequently obtained by lumbar puncture as part of a full septic workup in these patients.[ncbi.nlm.nih.gov]

Treatment

  • In three children who were tested, serum carnitine levels (total and free) were normal before starting L-carnitine treatment.[ncbi.nlm.nih.gov]
  • Delay in diagnosis and treatment may be associated with decreased success rates of reduction by barium enema, and increased rates of complications of perforation, peritonitis, sepsis, and death.[ncbi.nlm.nih.gov]
  • Treatment approaches for insomnia and fatigue are also discussed and reviewed, including the role of hypnotics, psychotropics, hormonal agents, and alternative therapies.[ncbi.nlm.nih.gov]
  • Treatment with anticoagulants does not appear necessary.[ncbi.nlm.nih.gov]
  • Once the cause has been diagnosed, it is important that you follow your doctor’s recommendations regarding treatment of lethargy symptoms.[home-remedies-for-you.com]

Prognosis

  • What is the Prognosis for Fatigue? Can it Be Cured? Generally, the prognosis for fatigue is good, because many of the causes are relatively easy to treat.[emedicinehealth.com]
  • Prognosis Figure 1 Diagnostic protocol for patients with suspected CFS.[doi.org]
  • Prognosis of fatigue and functioning in primary care: a 1-year follow-up study. Ann Fam Med 2008 ; 6 : 519 –27. 32. Knottnerus JA, Starmans R, Vissers A. Diagnostische conclusies van de huisarts naar aanleiding van onverklaarde moeheid.[doi.org]

Etiology

  • […] stodgy •pedagogy • Georgie, orgy •ogee • Fuji • bhaji, budgie, pudgy, sludgy, smudgy •bulgy • bungee, grungy, gungy, scungy, spongy • allergy, analogy, genealogy, hypallage, metallurgy, mineralogy, tetralogy •elegy • antilogy, trilogy •aetiology ( US etiology[encyclopedia.com]

Epidemiology

  • […] aetiology ( US etiology), amphibology, anthology, anthropology, apology, archaeology ( US archeology), astrology, biology, campanology, cardiology, chronology, climatology, cosmology, craniology, criminology, dermatology, ecology, embryology, entomology, epidemiology[encyclopedia.com]
  • Chronic fatigue and chronic fatigue syndrome: clinical epidemiology and aetiological classification. Ciba Found Symp 1993 ; 173 : 23 –31. 37. Ridsdale L, Evans A, Jerrett W, et al.[doi.org]
  • It must be assumed that, since there are no accurate and realistic criteria for the diagnosis of CFS in adolescents and children, there are no accurate epidemiological data either.[doi.org]
  • Sethi , Sleep Disorders Associated with Parkinson's Disease: Role of Dopamine, Epidemiology, and Clinical Scales of Assessment , CNS Spectrums , 13 , S4 , (6) , (2008) .[dx.doi.org]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of fatigue and insomnia is discussed in this review, including their differential diagnoses as well as the emerging understanding of the roles of neurotransmitters, branched-chain amino acids, and inflammatory cytokines.[ncbi.nlm.nih.gov]
  • However, assessing fatigue is not easy since the symptom is inherently complex and the pathophysiology is not well explained [ 4, 5 ].[ncbi.nlm.nih.gov]
  • Jenkins, Dietary Fiber, Soluble and Insoluble, Carbohydrates, Fructose, and Lipids, The Microbiota in Gastrointestinal Pathophysiology, 10.1016/B978-0-12-804024-9.00022-7, (187-200), (2017).[doi.org]

Prevention

  • In addition, an exercise regime also helps reduce weight and boosts immunity thereby preventing other illnesses and conditions that may lead to lethargy as well.[home-remedies-for-you.com]
  • Tips for Preventing Fatigue The best way for patients to prevent fatigue from even happening is to increase their energy levels. They can do this by changing their dietary habits as well as by changing their daily routine.[naturalremedies.org]
  • Requests for Reprints: Keiji Fukuda, MD, MPH, Mailstop A15, Division of Viral and Rickettsial Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333.[doi.org]
  • This can not only put you behind on things you need to be doing, but it can also prevent you from enjoying life to its fullest.[healthguidance.org]
  • How Can You Prevent Fatigue? Fatigue prevention (both physical and mental) is possible in many people. Prevention of the underlying cause in almost every situation will prevent the symptom of fatigue.[emedicinehealth.com]

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