Tag Archives: Dx

Question?: Pdd Symptoms

Richard asks…

What illnesses are impossible to have a confirmed diagnosis on?

As I understand it, there are some illnesses out there that can only be diagnosed based on ruling out everything else. So my question is, what illnesses can someone have when all tests still show up normal?
Currently I’m studying medicine and as far as I know this is the topic after dehydration which we are doing now. I was hoping to get a little knowledge before hand but I haven’t got the books yet and the internet seems to be failing me? Thanks!

admin answers:

There are some diseases which can only be positively diagnosed after death and autopsies because there are currently no lab tests to use for positive diagnosis.

Parkinson’s disease and some of the parkinsonian conditions are a good example although that may change by the time you are out of med school. Look also at differential diagnoses.One problem is that the name Parkinson’s or Parkinson disease is actually a collection of syndromes with varying symptoms, rates of progression and differing genetic and environmental triggers. Not to mention the related parkinsonian conditions which may or may not be l-dopa responsive.

Lab tests are usually conducted in a suspected PD DX to rule out other conditions.

If doctors could recognize precursor symptoms of conditions such as PD, treatments and therapies might be started much earlier and that might delay onset of some symptoms and progression of others for considerable time.

Lewy body disease is an excellent example. Certain symptoms can overlap with PD and AD. Does a person have Parkinson’s disease with dementia (PDD)? Lewy Body disease? Alzheimer’s? Dementia? Other mental illness may be seen to manifest symptoms which can be associated with several conditions some emotional/psychological and some chemical imbalance.

There are many conditions which are very difficult to diagnose especially when they occur in infants as you can read at the link below. I”m not going to cut and paste since the article is quite clear with additional links.
Here’s a cardiac condition very difficult to diagnose:

Some conditions are simply difficult to diagnose in the early stages. The problem is that without a positive early diagnosis the patient risks death or other debilitating conditions. A simple example is appendicitis. Or how about the headaches or nausea associated with meningitis which are usually seen as the flu?

Diagnostics are very difficult simply because patients may need to go years back to find the precursor symptoms (PD is a great example) or be reluctant to tell the doctor embarrassing issues which they don’t think are related.

All patients should be encouraged to come to that first appointment (unless it is the emergency room) with a printed list of symptoms dating back several years if they still persist. And an extended blood relative family medical history plus a list of medications including OTCs which they have taken in recent.

Several autoimmune conditions are difficult to diagnose because they can be confused with another condition. Examples include Scleroderma and Lupus. Digestive disorders fall into the same category because symptoms overlap.

Oddly enough some of the cancers are also difficult to diagnose although I am still at a loss to understand exactly why. Breast cancer, lung cancer and colon cancer have been misdiagnosed as simply health issues for years.

Rare disorders are difficult to diagnose because most physicians simply aren’t familiar with the symptoms and assume other causes.

I think you would be better served with difficult rather than impossible. If the disease or condition has a name, someone has diagnosed it.

Listening is key.The difference between a teen and an infant is huge. One can tell you the other cannot communicate except to indicate pain. Knowing the questions to ask is so important. Telling patients to come with written lists is another.

Too often doctors rely on patients to provide the best clues. That isn’t always possible. Better diagnostic check lists would be of significant value. Diagrams could be included. Frequent revisions would be required.With a check list, the doctor is reading and thinking about both the questions and the answers and the patient is listening and responding.

Consider also that ‘impossible to confirm diagnoses” might actually refer to diagnoses which can’t be diagnosed by physical exam alone.

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Question?: Schizophrenia Stories

Michael asks…

Schizophrenia?? need help…!! stories, anything…?

how does it affect the person living with the disorder?
how is the disorder best managed?

admin answers:

I’m not sz but hear voices,I also know many people that are sz.

It really depends on the severity of the symptoms. I know many people that live some what of a normal life. Many have had there symptoms go away for many years only to return later in life.

I know some people that are unable to handle day to day life and are hospitalized many times. I also know many that there meds work for them and are doing OK. Although meds can stop working and must be changed a lot.

Many of my friends have gone to collage, been married and have a family, now that doesn’t always work out.

I think that you must educate yourself and the people in your life. These people can see an episode coming on when the person with sz does not. You must keep in contact with your pdoc, eat healthy and find what works best for you.Therapy can help a great deal as it is hard for them to find people they can trust. Many of them live a very isolated life as mental illness has a very bad stigma. Also they have a lot of paranoia. Anyone who hears bad voices can somewhat relate to people that are sz. Some of the symptoms are the same. We try and teach new comers that our voices are liars and have no powers.

But dx at an early age you can learn best how to cope with it and most of them do much better. By the time they have had sz for many years they have learned to cope much better.

This is what I have learned in a suport group I’m in for people who hear voices. Many of these people are my main support and have educated me so much. I was so afraid to tell anyone that I heard voices because I thought since I heard them meant I was sz. Now I see things in a different light. I consider most of my friends in my suport group my very best friends.

Take care

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Question?: Pdd-nos Checklist

Donna asks…

Autism / Asperger’s Questions?

I strongly suspect my 2 1/2 year old son has some form of Autism. The only thing that makes everybody a little skeptical is that he shows plenty of emotion, imaginative play, and really looks at you when he’s communicating with you.

Now the reasons I think he is Autistic are that he has yet to develop speech, no social play with his age group, stacks or lines up objects, sometimes tiptoe walks among other little things.

Is it possible for a child that has these characteristics to have Autism or even Aspergers?

Currently I live in Mexico and they more reluctant to diagnose you with Autism here and appears they are not as prepared to deal with this disease than we are in the states(I am an American Citizen married to Mexican woman)

What are some effective home therapies that me and my wife can use on my son while we wait for his documents to arrive so we can have him treated in the States?

Thank You

admin answers:

You aren’t going to come by a diagnosis of asperger’s with a speech delay, that isn’t to say that is not what it is, and that could be flushed out later. Still since the DSM-IV states you cannot have a speech delay and asperger’s only really cutting edge docs will give a r/o dx of asperger’s syndrome with a speech delay only not at his age usually, about 4.

YES, its very possible to have some features of autism, some typical features, and even some asperger features. This has a diagnosis of its own, called PDD.NOS (pervasive developmental delay not otherwise specified. It’s atypical autism, or autistic features.

I remember being confused about the PDD.NOS diagnosis, as I watched my 2 yr old son in the neurologist office feeding a baby while talking on the room phone (that’s a lot of pretend play going on for an autistic kid, or so I thought). He also lined toys up at that age.

Here is a great indicator as to where your son is falling on the spectrum:

Try to make his repetitive play functional. Try to elaborate it. Set up 1:1 playdates. Look into educating yourself on sensory integration. Look at the sensory processing checklist


For speech, receptive (understanding of language) comes first, so focus on that. Do not use flashcards, they hold little interest to kids of this population, anything 2-D skip. Get the actual object. Ask him to differentiate between 2 common objects. A duck, a ball. Then try to get him to identify the one you are asking for.

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Question?: Autism Symptoms In Adults Checklist

Nancy asks…

Help I think I got Aspergers syndrome?

Im 14 and I have a really hard time talking to people, Most of the time I just don’t talk to people because normally I try to say something and I end up making it weird by mixing my words around. I feel like I don’t think, as if I am brain dead. I have been homeschooled half my life and I am never really put into social situations and it really makes me very sad. I can’t even make smalltalk because I don’t know what to say…. I want friend’s but I feel different then them. Almost like everyone is popular and im the shy kid in the corner. I feel very depressed, Almost as if I have no thoughts ideas or imagination, I have thought over suicide and I used to cut myself but I stopped. Are these signs of aspergers or am I just depressed and really socially unskilled because or homeschooling…. Help? >:
Also I really don’t want to spend a lot of money for brain scans or whatever docters do to people. :/

admin answers:

There are plenty of symptom checklists out there, so I won’t cut and paste them for you. While most individuals with a personality disorder on the autism spectrum are diagnosed at an age younger than yourself, Asperger’s many times can go unnoticed until the individual becomes older and the necessary social interactions that go along with becoming an adult become manifest.

You don’t get brain scans (unless you want to, or are part of a study), the diagnosis is made through observation, interview with you, and with your parents (together and separately) to establish the veracity of claims, and certain patterns from childhood, and finally a battery of psychological tests, often a minimum of an IQ test (there will often be large discrepancies between VCI and PSI for instance), a personality test appropriate for age (adults often take the MMPI-2), a psych. History, etc. The depression Dx is more easily arrived at, and far more prevalent than a personality disorder, but pursue it if you believe it’s something you have. Look at the vignettes of people with the disorder and if you say to yourself “That’s me!” than you should definitely seek out a diagnostic test to rule it either in or out.

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Question?: Pdd Symptoms

Carol asks…

Does anyone else with an autistic child have issues with them not wanting to write in school?

My son is 7 years old and in the 2nd grade. He has mild symptoms of autism and is over average in all his classes. Lately, his teacher has struggled with getting him to write in his journal, he doesn’t like to write longer than one sentence. Is this a normal symptom of autism? Anyone else have this problem? Any advice on how to coach him on writing?

admin answers:

I can’t understand why mcc has all those thumbs down when the answer is correct, yes its a lack of theory of mind.

Mild autism, high functioning autism, asperger’s syndrome, provincial autism, autistic features, and PDD.NOS are all used interchangeably to describe someone mildly on the autistic spectrum.

My son is in first grade and is 7 years old, he has a dx of PDD.NOS or autistic features. Yes, he struggles with journal writing. We have accomodations in his IEP for this. During journal writing, he can either scribe, or someone prompts him. You could get the journal topic early and do pre-teaching. They remember everything so that won’t be a problem, or you could try to get a 1:1 during journaling time to prompt him. For him to be the most independent, try the pre-teaching first. It is very difficult to retrieve complete thoughts that are related and flow. My son has severe pragmatic issues and writing thoughts that are related is super difficult without prompting. My son has to journal what he did over the weekend. We go over it in the car on the way to school. So I ask him what did you do? He will say watch tv. Ok what did you watch? Have you seen it before? Was it good? Did you eat while watching it? Where did you watch it? With this prompting, he can go into school and write: I watched spiderman I on DVD on Friday night in my room. I ate popcorn. It is a good movie.

Another ex. What did you do? Went to a party. Whose party? Where was it at? What did you eat? I try to tell my son to go through all the
“wh-” questions and answer them when writing. If we don’t rehearse it though, he will write I went to a party. Cake pool present. With rehearsing he can write: I went to a pool party. It is my friend Jonathan. He is 7. We had cake. He opened his presents. He got a car.

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Question?: Pdd Nos Symptoms

Sandra asks…

If my child tends to ignore his name at times and at times avoids eye contact, does this make him autistic?

My son is 10 months old and he’s very active and enjoys playing as well as with others. But my fiance and I are worried about him ignoring his name at times and a lot of times he has poor eye contact, here and there we notice small things that keep building up to the question, could he be autistic?

admin answers:

We had my middle son at the neurologists office at 9 months for precisely the same concerns. He did get an autistic dx that day, PDD.NOS which is atypical autism. At 9 months my son also did not wave, and he repetitively put things in a bucket and took them out. He is now 3.5yrs., and nobody questions that he is on the spectrum anymore. At 12 months, specialists accurately dx kids on the spectrum 60-80 percent of the time.

It does not mean that your child is definately on the autistic spectrum, only that right now he has a couple of autistic characteristics. Some kids have a quirky period and work themselves out. If it is an autistic spectrum disorder symptoms will become more pronounced, the worst being between 2-3 years old.

I did the following assessment questionaire:

At 9 months my son scored a 49 (over 50 is considered a possible PDD). At his highest between 2-3 he scored an 88 (still in the mild range of 50-100). Now at 3.5 he scores an 82

The spectrum is very broad. We have gone through early intervention which is a free program 0-3 yrs, now he attends the free public preschool for delayed children.

This son always smiled, gave hugs freely, and didn’t flap at all until after 2.

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