PEDIATRICS Vol. 117 No. 5 May 2006, pp. 1861 (doi:10.1542/peds.2005-3145)
Masturbation in Infancy and Early Childhood Presenting as a Movement Disorder
John B. Bodensteiner, MDDepartment of Pediatric Neurology
Barrow Neurological Institute
St Joseph's Children's Health Center
Phoenix, AZ 85013
Raj D. Sheth, MD
Departments of Neurology and Pediatrics
University of Wisconsin
Madison, WI 53792
To the Editor.
We read with great interest the recent article by Yang et al "Masturbation in Infancy and Early Childhood Presenting as a Movement Disorder: 12 Cases and a Review of the Literature."1 Their findings further support the utility of home video recordings of "spells" in assisting evaluation into the nature of suspicious paroxysmal events. Reliance on the clinical history is subjective by nature and often frustrating because the child often appears entirely healthy at the office visit. In such situations, home video recordings offer an inexpensive adjunct in the evaluation of the events in question. This is true whether the event is thought to be a seizure, which is frequently the case, or a movement disorder as in the authors' cases. In our experience, however, the home video recordings are frequently incomplete or difficult to interpret and often miss important details necessary to identify the true nature of the event.2,3 In our case, masturbation was mistaken for seizure activity, and the infant was placed on increasing doses of phenobarbital because the spells did not stop with initial small doses. In this instance, the family had a video recording of several spells that had been reviewed by the treating physician, but the nature of the events escaped identification because of lack of thorough and systematic evaluation of the video by the treating neurologist. We feel that the utility of home video recording of paroxysmal events can be greatly enhanced by (1) provision of a brief checklist to parents to help them in recording the necessary features of a spell (Table 1) and (2) systematic evaluation of the video recording by the physician in the same way that a radiograph or neuroimaging study would be reviewed.2 These simple instructions to the parents and systematic review of the recorded events, including precipitating factors and the evolution and resolution of the event, will enhance the effectiveness of home video recordings as a diagnostic tool. Appropriate use of the information from video recording of spells as an adjunct to the standard clinical history and examination often allows the physician to avoid unnecessary investigations and referrals, as Yang et al have suggested.
|
REFERENCES
- Yang ML, Fullwood E, Goldstein J, Mink JW. Masturbation in infancy and early childhood presenting as a movement disorder: 12 cases and a review of the literature.
Pediatrics. 2005;116
:1427
–1432
[Abstract/Free Full Text] - Sheth RD, Bodensteiner JB. Effective utilization of home video recordings for the evaluation of paroxysmal events in pediatrics.
Clin Pediatr (Phila). 1994;33
:578
–582
[Abstract/Free Full Text] - Sheth RD, Bodensteiner JB. Infantile masturbation mimicking seizures: a video demonstration [abstract]. Ann Neurol. 1994;11 :105
PEDIATRICS (ISSN 1098-4275). ©2006 by the American Academy of Pediatrics
CiteULike 
Connotea 
Del.icio.us 
Digg 
Facebook 
Reddit 
Technorati 
Twitter What's this?
Related articles in Pediatrics:
- Masturbation in Infancy and Early Childhood Presenting as a Movement Disorder: In Reply
- Jonathan W. Mink, Michele L. Yang, Erika Fullwood, and Joshua Goldstein
Pediatrics 2006 117: 1861-1862.[Extract] [Full Text]
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
