The Child with a Stiff Neck

Abstract

The child with a stiff neck can be a challenging diagnostic exercise. Four unusual examples of acute neck stiffness, not associated with meningitis, are presented to illustrate the various pathologic conditions which may produce this symptom. A differential diagnostic schema is sug gested on the basis of pathologic and physiologic alterations of cervical and paracervical anatomic structures.

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References

Osler W. The principles and practice of medicine, 8th ed. New York: D Appelton & Company, 1918.

Vaughn VC , McKay RJ , Newson WE , eds. Textbook of Pediatrics. Philadelphia: WB Saunders, 1975.

Rudolph AM , ed. Pediatrics. New York: Appleton-Century-Crofts, 1977.

Cooke RE , ed. The biological basis of pediatric practice. New York: McGraw-Hill , 1968.

Hoekelman RA , ed. Principles of pediatrics—health care of the young. New York: McGraw-Hill , 1978.

Menkes JH Textbook of child neurology. Philadelphia: Lea and Febinger, 1980.

Swaiman KF , Wright FS The practice of pediatric neurology. St. Louis : CV Mosby, 1975.

Holt LE Jr, Mclntosh R. : Holt's Diseases of Infancy and Childhood, 11th ed. New York: Appleton-Century Co, 1936.

Wechsler IS A textbook of clinical neurology. Philadelphia : WB Saunders, 1943.

10.

Holt LE , McIntosh R, Barnett , eds. Pediatrics. New York: Appelton-Century-Crofts, 1962.

11.

Nelson WE , eds. Textbook of pediatrics, 8th ed. Philadelphia : WB Saunders, 1964.

12.

Andiman WA The Epstein-Barr virus and EB virus infections in childhood. J Pediatr 1979;95:171-82.

13.

Lederer FL Diseases of ear, nose and throat—principles and practice of otolaryngology . Philadelphia: FA Davis, 1952:727.

14.

Lovell WW , Winter RB Pediatric orthopaedics. Philadelphia: JB Lippincott, 1978.

15.

Lyon LW Neurological manifestations of cat-scratch disease. Arch Neurol 1971;25:23-7.

16.

Steiner MW , Vuckovitch D. , Hadawi SA Cat-scratch disease with encephalopathy. J Pediatr 1963;62:514-20.

17.

Illingsworth RS Myositis ossificans progressiva. Arch Dis Child 1971;46:264-8.

18.

Heffron R. Pneumonia. Cambridge, Massachusetts, 1939:488-90.

19.

Horowitz S. Otogenic intracranial hypertension. J Laryngol Otol 1949;63:363-81.

20.

Gupta JM , Lovejoy FH Acute phenothiazine toxicity in childhood: a five year survey. Pediatrics 1967;39:771-4.

21.

Greer Wer. Arachnidism: effect of calcium gluconate in six cases. N Engl J Med 1949;240:5-8.

22.

Stahnke HL The Arizona scorpion problem. Ariz Med 1950 ;7:23-9.

23.

Tanis AL Lead poisoning in children. Am J Dis Child 1955;89:325-31.

24.

Kanner L. Child psychiatry Springfield, IL: Charles C Thomas, 1966:655.

25.

Silver HK , Robertson WO , Wray JD , et al. Involvement of the central nervous system in infectious mononucleosis in childhood. Am J Dis Child 1956;91:490-4.

26.

Illingsworth RS Common symptoms of disease in children, 5th ed. Oxford: Blackwell Scientific Publications, 1975:228-30.

27.

Schanno JR , McDonald JJ , Peacock BR Meningismus: a presenting sign in ruptured appendicitis of infancy . Med Ann DC 1960;29:535-9.

28.

Merritt HH , Fremont-Smith F. The cerebrospinal fluid. Philadelphia: WB Saunders, 1938:35, 253.

29.

Fremont-Smith F. , Dailey ME , Thomas GW Dilution of blood and cerebrospinal fluid in fever. J Clin Invest 1929;6:9.

30.

Fishman RA Cerebrospinal fluid in disease of the nervous system. WB Saunders, 1980:276.

31.

Jones PG Torticollis in infancy and childhood. Springfield, IL: Charles C Thomas, 1968.

32.

Ribera AB , Cooper IS The natural history of dystonia musculorum deformans: a clinical study . Arch Pediatr 1960;77:55-71.

33.

Byers RK , Gilles FH , Fung C. Huntington's disease in children. Neurology 1973;23:561-9.

34.

Menelaus MB : Discitis J Bone Joint Surg [Am] 1964;46:16-23.

35.

Krugman S. , Ward R. Infectious disease of children. St. Louis: CV Mosby, 1968:396.

36.

Clemens HH Exanthem subitum (roseola infantum)—report of eighty cases. J Pediatr 1945;26:66-77.

37.

Snyder CH Paroxysmal torticollis of infancy. Am J Dis Child 1969;117:458-60.

38.

Strom J. Further experience of reactions, especially of a cerebral nature, in conjunction with triple vaccination: a study based on vaccinations in Sweden 1959-65. Br Med J 1967;4:320-3.

39.

Davies DM Epidemic cervical myalgia. Lancet 1960;1:1275-7.

40.

Weiss S. , Carter S. Course and prognosis of acute cerebellar ataxia in children. Neurology 1959;9:711-21.

41.

Matson DD Neurosurgery of infancy and childhood. Springfield, IL : Charles C Thomas, 1969:652-4.

42.

Stein M. , Buchta R. , Raszynski A. , et al. Intussusception West J Med 1979 ;130:35-42.

43.

Kawasaki T. , Kosaki F. , Okawa S. A new acute febrile mucocutaneous lymph node syndrome (MLNS) prevailing in Japan. Pediatrics 1974;54:271-6.