Neuromyelitis optica (NMO; Devic syndrome) is a clinically defined, severe CNS demyelinating syndrome characterized by optic neuritis (ON) and acute myelitis; the presence of CNS symptoms outside the optic nerves and spinal cord has until recently excluded the diagnosis.
I. Ocular symptoms: a positive response to at least one of the following questions:
Have you had daily, persistent, troublesome dry eyes for more than 3 months?
Do you have a recurrent sensation of sand or gravel in the eyes?
Do you use tear substitutes more than 3 times a day?
- Idiopathic insomnia: Insomnia arising in infancy or childhood with a persistent, unremitting course
- Psychophysiologic insomnia: Insomnia due to a maladaptive conditioned response in which the patient learns to associate the bed environment with heightened arousal rather than sleep; onset often associated with an event causing acute insomnia, with the sleep disturbance persisting despite resolution of the precipitating factor
- Paradoxical insomnia (sleep-state misperception): Insomnia characterized by a marked mismatch between the patients description of sleep duration and objective polysomnographic findings Continue reading
A firm diagnosis requires that two major or one major and two minor criteria are satisfied, in addition to evidence of recent streptococcal infection.
Amsterdam Criteria (1991)
Three or more relatives with colorectal cancer, plus all of the following:
One affected patient should be a first-degree relative of the other two;
Colorectal cancer should involve at least two generations;
At least one case of colorectal cancer should have been diagnosed before the age of 50 years.
Definite diagnosis of CD
History and clinical presentation compatible with CD
- Serological screening compatible with CD: antigliadin antibody (AGA) antiendomysium antibody (AEA), tissue transglutaminase (tTG) antibody.
- Histological findings compatible with CD: villous atrophy
- Obvious clinical and serological response to a gluten free diet (GFD)
- Subject >2 years old
- Rule out other clinical conditions mimicking CD Continue reading
For classification purposes, a patient is said to have RA if he or she has satisfied at least 4 of the following 7 criteria. Criteria 1 through 4 must have been present for at least 6 weeks. Patients with 2 clinical diagnoses are not excluded. Designation as classic, definite, or probable RA is not to be made.