12 years male , unable to concentrate on studies,getting weaker marks progressive since one year , memory loss particularly short term, not actively participating which he involved earlier very easily to sibs and friends, complaints given by parents past history 4 years back I admitted him as measles encephalitis,discharge fully cured I had attended this child delivery personally no antenatal perinatal asphyxiation events or significant history which can be corelated development normal MRI BRAIN NORMAL now since last one year complaints of about mentioned as well finger deviation without joint pain,no early morning stiffness,no history of trauma I had corelated with bowel disease , autoimmune joint diseases, vitamin D deficiency , taken orthopedic opinion too , kindly suggest further work up I1. is memory loss or behaviour problem related to SSPE or something else ? 2. joint problem unable to correlated?

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C/o Poor concentration, forgetfulness, gradual fall in academic performance, decreased social interaction. Past H/o Measles encephalitis. MRI head : Normal.. Vit D deficiency.. Deviation of fingers.. Needed face to face interaction/interview with the patient to assess whether forgetfulness was true or false (Pseudodementia). On the basis of the above history following differential can be made. 1. Behavioural and cognitive change is a part of the primary disease process (if there is Dementia) 2. Depression secondary to the primary disease (if there is pseudodementia). Take an opinion by direct consultation from any Psychiatrist.
Sir Are u thinking in terms of NDD SSPE is usually fatal with or without Rx So unlikely Yes there is VIT D deficiency But unlikely to cause loss of memory Finger deviation I'm not sure may be trauma related Show him to child psychologist
Yes towards NDD surely no history of trauma Interesting patient
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Vitamin D deficiency present, may explain Regarding TETANY.MRI BRAIN : NORMAL. MEMORY LOSS /BEHAVIOR PROBLEMS : BOTH CONDITIONS NEED TO BE ADDRESSED & EVALUATION BY THE PEDIATRIC PSYCHIATRIST. NEEDS I.Q. TESTING TOO.
Sir what is serum calcium level and serum phosphate ? Rule out rickets. And for lack of concentration Can be treated with amphetamine or methylphenidate (not sure)
Vit D def dementia finger ,toe? Connective tissue dis progressive
Any joint hypermobility? Cardiac issue?
No laxity joint ECHOCARDIOGRAPHY NORMAL Superb thought Manish ? Marfan are you thinking
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