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
1.
Osler W.
The principles and practice of medicine , 8 th ed. New York : D Appelton & Company , 1918 .
2.
Vaughn VC
,
McKay RJ
,
Newson WE
, eds. Textbook of Pediatrics . Philadelphia : WB Saunders , 1975 .
3.
Rudolph AM
, ed. Pediatrics . New York : Appleton-Century-Crofts , 1977 .
4.
Cooke RE
, ed. The biological basis of pediatric practice . New York : McGraw-Hill , 1968 .
5.
Hoekelman RA
, ed. Principles of pediatrics—health care of the young . New York : McGraw-Hill , 1978 .
6.
Menkes JH
Textbook of child neurology . Philadelphia : Lea and Febinger , 1980 .
7.
Swaiman KF
,
Wright FS
The practice of pediatric neurology . St. Louis : CV Mosby , 1975 .
8.
Holt LE
Jr,
Mclntosh R.
: Holt's Diseases of Infancy and Childhood , 11 th ed. New York : Appleton-Century Co , 1936 .
9.
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 , 8 th 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 , 5 th 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 .
