Epilepsi Ayırıcı Tanısında Munchausen By Proxy Sendromu (Bir Başkasına Yüklenen Yapay Bozukluk)
Özet
Munchausen by Proxy Sendromu, çocuk bakımını üstlenen kişiler (anne, baba, bakıcı vb.) tarafından, çocukta hastalık hikayesinin veya belirtilerinin oluşturulduğu, nedeni bulunamayan, ısrarlı, tekrarlayan ve çocuğun klinik bulgularıyla uyumlu olmayan belirtilerin bulunduğu özel bir çocuk istismarı biçimidir. Bulgular arasında kanama, nöbet, havale, apne, ishal, kusma, ateş, döküntü gibi çeşitli semptomlar yer alabilir. Bunlar belirtiler arasında nöbet, konvülzyon gibi nörolojik semptomlar da sıklıkla gözlemlenir. MbBP sendromunda epilepsi ayrıcı tanısının yapılması, çocuğun istismarının durdurulmasının yanı sıra yapay semptomlar yüklenen çocuğun gereksiz ilaç kullanmasını, tedavide zaman kaybını ve sağlık sisteminde gereksiz maliyeti önlemeye yardımcı olur. Bu bölümde, çocukluk çağı epilepsisi ayrıcı tanısında dikkate alınması gereken Munchausen by Proxy Sendromu ele alınacaktır.
Munchausen by Proxy Syndrome is a special form of child abuse in which the caregivers (mother, father, caregiver, etc.) create a history and/or symptoms of the disease in the child with symptoms that are unexplained, persistent, recurrent and incompatible with the clinical findings of the child. Symptoms may include bleeding, seizures, convulsions, apnea, diarrhea, vomiting, fever, rash. Neurological symptoms such as seizures and convulsions are also frequently observed. Making a differential diagnosis of epilepsy in MbBP syndrome helps to stop child abuse as well as to prevent unnecessary medication, loss of time in treatment and unnecessary costs in the healthcare system. In this chapter, Munchausen by Proxy Syndrome, which should be considered in the differential diagnosis of childhood epilepsy, will be discussed.
Referanslar
Ekici A. Epilepsinin patofizyolojisi. Kumandaş S, Canpolat M (ed.), Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p. 8-14.
Eldeş Hacıfazlıoğlu N, Yılmaz Y. Epilepsili Çocuklarda Mortalite, Eşlik Edebilen Tıbbi Durumlar ve Yaşam Kalitesi. Kumandaş S, Canpolat M (ed.), Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.264-270
Canpolat M, Acer H, Kumandaş S. Nonepileptikparoksismal olaylar. Kumandaş S, Canpolat M, editörler. Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.210- 231.
Olry R, Haines DE. Historical and literary roots of Münchhausen syndromes: as intriguing as the syndromes themselves. Progress in Brain Research. 2013;206: 123-141. doi: 10.1016/B978-0-444-63364-4.00024-7.
Meadow R. ABC of child abuse. Munchausen syndrome by proxy. British Medical Journal. 1989;299(6693): 248-250. doi: 10.1136/bmj.299.6693.248.
Rosenberg DA. Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse and Neglect. 1987;11(4): 547-563. doi: 10.1016/0145-2134(87)90081-0.
American Psychiatric Association. Diagnosticand Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013.
Fehnel CR, Brewer EJ. Munchausen's syndrome with 20-year follow-up. American Journel of Psychiatry. 2006;163(3): 547. doi: 10.1176/appi.ajp.163.3.547-a.
Krahn LE, Li H, O'Connor MK. Patients who strive to be ill: factitious disorder with physical symptoms. American Journel of Psychiatry. 2003;160(6):1163-8. doi: 10.1176/appi.ajp.160.6.1163.
Jaghab K, Skodnek KB, Padder TA. Munchausen's Syndrome and Other Factitious Disorders in Children: Case Series and Literature Review. Psychiatry (Edgmont). 2006;3(3): 46-55.
Flaherty EG, Macmillan HL; Committee On Child Abuse And Neglect. Caregiver-fabricated illness in a child: a manifestation of child maltreatment. Pediatrics. 2013;132(3): 590-597. doi: 10.1542/peds.2013-2045.
McClure RJ, Davis PM, Meadow SR, et al. Epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Archives of Disease in Childhood . 1996;75(1): 57-61. doi: 10.1136/adc.75.1.57.
Tamay Z, Akcay A, Kilic G, et al. Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy. Child: Care, Health and Development. 2007;33(4): 496-499. doi: 10.1111/j.1365-2214.2007.00731.x.
Roesler TA, Jenny C. Medical Child Abuse: Beyond Munchausen Syndrome by Proxy, 1st ed. American Academy of Pediatrics, Elk Grove Village; 2009.
Bools C. Fabricated or Induced Illness in a Child by a Carer: A Reader, 1st ed, Radcliffe, New York 2007.
Bass C, Glaser D. Early recognition and management of fabricated or induced illness in children. Lancet. 2014;383(9926): 1412-1421. doi: 10.1016/S0140-6736(13)62183-2.
Bass C, Jones D. Psychopathology of perpetrators of fabricated or induced illness in children: case series. The British Journal of Psychiatry . 2011;199(2): 113-118. doi: 10.1192/bjp.bp.109.074088.
Yates G, Bass C. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases. Child Abuse and Neglect. 2017;72: 45-53. doi: 10.1016/j.chiabu.2017.07.008.
Abeln B, Love R. An Overview of Munchausen Syndrome and Munchausen Syndrome by Proxy. Nursing Clinics of North America. 2018;53(3): 375-384. doi: 10.1016/j.cnur.2018.04.005.
Vaught W. Parents, lies, and videotape: covert video surveillance in pediatric care. Journal of Clinical Ethics. 2004;15(2): 161-172.
Hall DE, Eubanks L, Meyyazhagan LS, et al. Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases. Pediatrics. 2000;105(6): 1305-1312. doi: 10.1542/peds.105.6.1305.
İnce T, Yurdakök K. Munchausen Syndrome by Proxy; A Serious Child Abuse Form. Türkiye Çocuk Hastalıkları Dergisi. 2014; 8(3): 165-170.
Sharif I. Munchausen syndrome by proxy. Pediatrics in Review. 2004;25(6): 215-216. doi: 10.1542/pir.25-6-215.
Bools CN, Neale BA, Meadow SR. Follow up of victims of fabricated illness (Munchausen syndrome by proxy). Archives of Disease in Childhood. 1993;69(6): 625-630. doi: 10.1136/adc.69.6.625.
Referanslar
Ekici A. Epilepsinin patofizyolojisi. Kumandaş S, Canpolat M (ed.), Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p. 8-14.
Eldeş Hacıfazlıoğlu N, Yılmaz Y. Epilepsili Çocuklarda Mortalite, Eşlik Edebilen Tıbbi Durumlar ve Yaşam Kalitesi. Kumandaş S, Canpolat M (ed.), Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.264-270
Canpolat M, Acer H, Kumandaş S. Nonepileptikparoksismal olaylar. Kumandaş S, Canpolat M, editörler. Çocukluk Çağı Epilepsileri. 1. Baskı. Ankara: Türkiye Klinikleri; 2020. p.210- 231.
Olry R, Haines DE. Historical and literary roots of Münchhausen syndromes: as intriguing as the syndromes themselves. Progress in Brain Research. 2013;206: 123-141. doi: 10.1016/B978-0-444-63364-4.00024-7.
Meadow R. ABC of child abuse. Munchausen syndrome by proxy. British Medical Journal. 1989;299(6693): 248-250. doi: 10.1136/bmj.299.6693.248.
Rosenberg DA. Web of deceit: a literature review of Munchausen syndrome by proxy. Child Abuse and Neglect. 1987;11(4): 547-563. doi: 10.1016/0145-2134(87)90081-0.
American Psychiatric Association. Diagnosticand Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013.
Fehnel CR, Brewer EJ. Munchausen's syndrome with 20-year follow-up. American Journel of Psychiatry. 2006;163(3): 547. doi: 10.1176/appi.ajp.163.3.547-a.
Krahn LE, Li H, O'Connor MK. Patients who strive to be ill: factitious disorder with physical symptoms. American Journel of Psychiatry. 2003;160(6):1163-8. doi: 10.1176/appi.ajp.160.6.1163.
Jaghab K, Skodnek KB, Padder TA. Munchausen's Syndrome and Other Factitious Disorders in Children: Case Series and Literature Review. Psychiatry (Edgmont). 2006;3(3): 46-55.
Flaherty EG, Macmillan HL; Committee On Child Abuse And Neglect. Caregiver-fabricated illness in a child: a manifestation of child maltreatment. Pediatrics. 2013;132(3): 590-597. doi: 10.1542/peds.2013-2045.
McClure RJ, Davis PM, Meadow SR, et al. Epidemiology of Munchausen syndrome by proxy, non-accidental poisoning, and non-accidental suffocation. Archives of Disease in Childhood . 1996;75(1): 57-61. doi: 10.1136/adc.75.1.57.
Tamay Z, Akcay A, Kilic G, et al. Corrosive poisoning mimicking cicatricial pemphigoid: Munchausen by proxy. Child: Care, Health and Development. 2007;33(4): 496-499. doi: 10.1111/j.1365-2214.2007.00731.x.
Roesler TA, Jenny C. Medical Child Abuse: Beyond Munchausen Syndrome by Proxy, 1st ed. American Academy of Pediatrics, Elk Grove Village; 2009.
Bools C. Fabricated or Induced Illness in a Child by a Carer: A Reader, 1st ed, Radcliffe, New York 2007.
Bass C, Glaser D. Early recognition and management of fabricated or induced illness in children. Lancet. 2014;383(9926): 1412-1421. doi: 10.1016/S0140-6736(13)62183-2.
Bass C, Jones D. Psychopathology of perpetrators of fabricated or induced illness in children: case series. The British Journal of Psychiatry . 2011;199(2): 113-118. doi: 10.1192/bjp.bp.109.074088.
Yates G, Bass C. The perpetrators of medical child abuse (Munchausen Syndrome by Proxy) - A systematic review of 796 cases. Child Abuse and Neglect. 2017;72: 45-53. doi: 10.1016/j.chiabu.2017.07.008.
Abeln B, Love R. An Overview of Munchausen Syndrome and Munchausen Syndrome by Proxy. Nursing Clinics of North America. 2018;53(3): 375-384. doi: 10.1016/j.cnur.2018.04.005.
Vaught W. Parents, lies, and videotape: covert video surveillance in pediatric care. Journal of Clinical Ethics. 2004;15(2): 161-172.
Hall DE, Eubanks L, Meyyazhagan LS, et al. Evaluation of covert video surveillance in the diagnosis of munchausen syndrome by proxy: lessons from 41 cases. Pediatrics. 2000;105(6): 1305-1312. doi: 10.1542/peds.105.6.1305.
İnce T, Yurdakök K. Munchausen Syndrome by Proxy; A Serious Child Abuse Form. Türkiye Çocuk Hastalıkları Dergisi. 2014; 8(3): 165-170.
Sharif I. Munchausen syndrome by proxy. Pediatrics in Review. 2004;25(6): 215-216. doi: 10.1542/pir.25-6-215.
Bools CN, Neale BA, Meadow SR. Follow up of victims of fabricated illness (Munchausen syndrome by proxy). Archives of Disease in Childhood. 1993;69(6): 625-630. doi: 10.1136/adc.69.6.625.
