Adolescent Medicine : A Handbook for Primary Care by Victor C. Strasburger

By Victor C. Strasburger

Designed for speedy reference in a hectic workplace, this guide is a concise, sensible consultant to daily scientific difficulties in adolescent drugs. This ready-reference guide is written through famous specialists to supply speedy, authoritative solutions to questions about universal scientific and behavioral difficulties in little ones. a number of tables, bulleted lists, and charts aid practitioners locate details quick, and a formulary bargains advice in prescribing for teenagers.

Coverage comprises each very important subject in adolescent gynecology and updated options for comparing and treating overweight childrens. different key issues addressed contain activities drugs, substance abuse, and adolescent violence and suicide.

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In JME, the seizures are usually responsive to AEDs. Phenytoin and carbamazepine can exacerbate this type of epilepsy; therefore, they should be avoided. Valproic acid causes weight gain, so the drugs of choice are lamotrigine or topiramate, as well as possibly a newer AED. JAE and GMA require lifelong treatment with AED. In MTLE, carbamazepine, oxcarbazepine, and gabapentin all can be effective AEDs. One third of patients with MTLE become resistant to AED therapy and require surgical intervention.

How do the headaches affect the patient’s family? • What is the family’s response to the patient’s pain? qxd 6/30/05 2:18 PM Page 27 Headache 27 B. Differential diagnosis: 1. Acute headache: Most acute, nonrecurrent headaches in adolescents are caused by upper respiratory infections, viral syndromes, and acute sinusitis. Migraine and tension-type headaches certainly may present as acute headache, but often are part of a chronic or recurrent headache pattern and should be diagnoses of exclusion in the patient with acute, severe headache.

NEEs are common in adolescents, with one series reporting them in 20% to 25% of children referred for evaluation. As listed in Table 4-3, the causes of NEE in adolescents are usually discernible by history. Making the diagnosis: A. History: Diagnosis of seizures begins, as always, with a thorough history. The history should emphasize past head trauma; illnesses that might have caused brain impairment; metabolic problems; history of seizures with fever as a small child; Table 4-3. qxd 7/1/05 6:54 PM Page 35 Seizures 35 III.

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