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Sandor Viski and Laszlo Olah

;8:1-7. 12. Homburg A-M, Jakobsen M, Enevoldsen E. Transcranial Doppler recordings in raised intracranial pressure. Acta Neurologica Scandinavica. 1993;87:488-493. 13. Hansen HC, Helme K. Validation of the optic nerve sheath response to changing cerebrospinal fluid pressure: Ultrasound findings during intrathecal infusion tests. J Neurosurg. 1997;87;34-40. 14. Helme K, Hansen HC. Fundamentals of transorbital sonographic evaluation of optic nerve sheath expansion under intracranial hypertension. I. Experimental study. Pediatr Radiol. 1966

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Neha Gupta and Chrystal Rutledge

. Definitive diagnosis is usually made by genetic testing. Structural abnormalities of the brain are quite common in PDCD. A case of a patient with a late-onset diagnosis of PDCD with proximal muscle weakness, lactic acidosis and a normal brain magnetic resonance imaging (MRI) with an unusual presentation is presented. Case Report A 20-month-old boy with a past medical history of developmental delay, hypotonia and feeding difficulty, presented to the emergency department (ED) with runny nose, cough, and increased work of breathing for five days. Birth history was

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Piero Portincasa, Emilio Molina-Molina, Gabriella Garruti and David Q.-H. Wang

associated with gallstones. During painful episodes, some non-specific gastrointestinal symptoms may occur. In about 60% of cases, pain radiates to the angle of the right scapula or shoulder, and in less than 10% of cases to the retrosternal area [ 27 , 31 ]. In two-thirds of patients, a colicky pain may be associated with the urgency to walk [ 32 ]. Nausea and vomiting [ 27 , 28 , 32 ], as well as diaphoresis may be related symptoms, while pain is usually not relieved by flatus or bowel movements [ 28 ]. Following a painful attack, physical examination may be normal