In his time, adolf wallenberg 18621949 was renowned for his careful history taking and neurological examination, and for his insistence on clinicopathological confirmation. Eating these indigestible things is considered as a syndrome when patient eat these things for more than a month at an age. The medical term comes from the latin for magpie pica pica, a bird that by folklore incessantly gathers objects to satiate its curiosity. While research into the condition is still in its infancy, patients still have the option of undertak. Wallenbergs syndrome journal of neurology, neurosurgery. Pica is occasionally a feature of mental problems including autism, schizophrenia, and developmental disorders. If pica is motivated by sensory feedback, an alternative method of feeling that sensation should be provided.
Wallenberg syndrome is a rare condition in which an infarction, or stroke, occurs in the lateral medulla. Lateral medullary syndrome an overview sciencedirect topics. The most common stroke of the vestibular system, first reported in the late 19th century, 31 is lateral medullary syndrome, also known as wallenberg syndrome. Signs and symptoms may include swallowing difficulties, dizziness, hoarseness, nausea and vomiting, nystagmus, and problems with balance. For example, anemia, usually from iron deficiency, may be the. Pica is the compulsive eating of material that may or may not be foodstuff. Therefore, a minimum of 2 years is suggested for a pica diagnosis. On vous dit tout sur ce trouble du comportement alimentaire. The pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a nonnourishing substance which can be relatively harmless, or potentially harmful for the health. Pica eating of numerous other substances, such as paper, tissues, wood, plastic straws, soap, cloth, car.
Wallenberg syndrome genetic and rare diseases information. Pica is a psychological disorder characterized by an appetite for substances that are largely nonnutritive, such as ice. An ageold eating disorder thats often missed mdedge. Despite much research on pica, there are still many knowledge gaps. Aug 02, 2019 in children and pregnant women, pica often goes away in a few months without treatment. Lateral medullary syndrome lms wallenberg syndrome. Pica is not uncommon among certain subgroups of people, such as individuals with mental retardation6,7 and pregnant women. Pica and rumination disorder in dsm5 t he major proposed change for both pica and rumination disorder in the diagnostic and statistical manual for mental disorders, fifth edition is their relocation from their current section, titled disorders usually first diagnosed in infancy, childhood, or adolescence,1 to the. Pica causes symptomes traitement pronostic prevention. Pica is an eating disorder typically defined as the persistent eating or mouthing of nonnutritive substances. Many terms have been coined to describe certain picas. Pica is characterized by an appetite for substances that are largely nonnutritive, such as paper, clay, metal, chalk, soil, glass, or sand. In these individuals, pica is a sign that the body is trying to correct a significant nutrient deficiency.
Pdf pica is a medical disorder in which a person is attracted toward nonfood stuff. Pica is a pattern of eating nonfood materials, such as dirt or paper. Lateral medullary syndrome is also called wallenbergs syndrome, posterior inferior cerebellar artery pica. It is believed that pica works as a soothing behaviour that relieves the anxiety. Ipsilateral hemiparesis with symptoms and signs of lateral medullary infarction were first described by opalski in 1946.
Infants and younger children typically eat paint, plaster, string, hair, or cloth. The pica syndrome is an eating disorder characterized by an excessive or abnormal desire to consume a nonnourishing substance which can be relatively harmless ice, or potentially harmful for. In some cases, a deficiency in iron, zinc, or another nutrient may be associated with pica. Wallenberg syndrome is a condition that affects the nervous system. Pica syndrome is a rare eating disorder that triggers cravings for objects that are not edible. The ischemia is a result of a blockage most commonly in the vertebral artery or the posterior inferior cerebellar artery. Discrimination training teaching the child to discriminate between edible and nonedible items and making them aware of the dangers some substances present to them. Pdf pathophysiology and management of pica researchgate.
Research among noninstitutionalized populations takes the form. Pdf childhood soil pica is associated with, and can be a cause of, iron deficiency. There are various definitions of pica but the most commonly used is the repeated consumption of nonedible items or items with no nutritional value. He was responsible for relating the olfactory system to recognition and taste for food. The eating behavior is not part of a culturally supported or socially normative practice.
Geophagia deliberate consumption of earth, soil or clay is the most common form of pica in people who live in poverty and people who live in the tropics and in tribeoriented societies. It is unclear how many children with pica intentionally consume dirt geophagy. Pica is developmentally normal for infants to mouth objects, which may accidentally lead to an infant ingesting a nonfood substance. Primary care physicians need to be aware of pica and proactively seek information about cravings or behaviors suggesting the condition from patients in highrisk populationspregnant women, children, immigrants and refugees, people with developmental disabilitiesor their caregivers. Although young children are curious about their environment and predictably put everything in their mouths, children with pica go beyond this simple exploration of their surroundings.
Among adults, pica can start during the first trimester of. Wallenberg syndrome pica syndrome lateral medullary. Article pdf available in australian family physician 425. Some people have uncontrollable hiccups, loss of pain and temperature sensation on one side of the face, andor weakness or numbness on one side of the body. Sensory deficits affecting the trunk torso and extremities on the opposite side of the infarction. Older children may eat animal droppings, sand, insects, leaves, or pebbles. Pica symptoms are related to the nonfood item he or she has eaten. Pica is a widespread practice in western kenya, southern africa, and india. Pica is an eating disorder in which a person eats things not usually considered food. This is most commonly due to occlusion of the intracranial portion of the vertebral artery followed by pica and its branches. Pica is an eating disorder that is characterized by the consumption of nonnutritive substance persistently for at least 1 month. Pica troubles mentaux manuels msd pour le grand public. Treating this deficiency with medication or vitamins often resolves the problems. Lateral medullary syndrome an overview sciencedirect.
According to the dsmv 20 pica is classified as an eating disorder in which an individual consumes nonfood substances at least once per month, at a developmental stage in which the behavior is inappropriate, and occurs in a culture that does not sanction such behavior. The inspiration was not only from my patients with wallenberg. However, several other disorders or conditions reportedly have been associated with wallenberg syndrome, including. Those who are pregnant and craving nonfood items should only be diagnosed with pica when their cravings lead to ingesting nonfood items, and the ingestion of those items poses a potential medical risk either due to. Pica is the persistent eating of substances such as dirt or paint that have no nutritional value. Dietitians should ask pregnant women with anemia about pica and should counsel women who report pica regarding the health risks associated with it.
Ascertainment of iron deficiency and depletion in blood donors through screening questions for pica and restless legs syndrome. Other children hold things in their mouths and move them around only swallowing the item occasionally. Pica is the persistent eating of substances such as dirt or paint that have no nutritional value the handbook of clinical child psychologycurrently estimates that prevalence rates of pica range. Atnairp pica guide for parents pica, the repeated eating of nonfood items, is the eating disorder most often displayed by children with autism. The material is often consumed in large quantities without regard for nutritional consequences. The major proposed change for both pica and rumination disorder in the diagnostic and statistical manual for mental disorders, fifth edition is their relocation from their current section, titled. The handbook of clinical child psychology currently estimates that prevalence rates of pica range from 4%26% among institutionalized populations. Cohen, in stroke rehabilitation fourth edition, 2016. Persons with mental retardation may have pica because of an inability to tell the difference between food and nonfood items. Pica, the repeated eating of nonfood items, is the eating disorder most often displayed by children with autism. For example, a child may eat food from a garbage can or bite off a piece of a toy plastic car and swallow it quickly. Although pica is commonly associated with children and pregnant women adults from all areas of the world are affected by this disorder as well. Pica can affect children, adolescents, and adults of any genders. Sep 07, 2016 associated with pica practices are associated with significantly lower maternal hemoglobin levels at delivery but are not associated with pregnancy outcomes.
Pica is a potentially lifethreatening disorder that is commonly observed in individuals with intellectual and developmental disabilities iddd. Those who are pregnant and craving nonfood items should only be diagnosed with pica when their cravings lead to ingesting nonfood items, and the ingestion of those items poses a potential medical risk either due to the quantity or type of item being ingested. Prevalence of pica in iron deficiency anemia in marrakech morocco. Pica syndrome is defined as a disorder in which a patients appetite is increased for indigestible substances such as chalk, clay, dirt, and sand. Available data suggest that pica eating and by extension, pica is rare in healthy children older than 2 years in the us.
The dsm5 is a teaching tool to aspiring clinicians, and aid in understanding the. Pica is the pathological craving for and eating of a nonnutritive item eg, clay, coal, paper or food ingredients flour, raw potatoes. Irondeficiency anemia and malnutrition are two of the most common causes of pica, followed by pregnancy. May 22, 2017 the most common underlying cause of wallenberg syndrome is a brain stem stroke in the vertebral or posterior inferior cerebellar arteries of the brain stem. The greatest risk factor for wallenberg syndrome is currently believed to be large artery atherosclerosis, which is often linked to a history of hypertension, diabetes, and smoking. The most common cause of wallenberg syndrome is an ischemic stroke in the va or pica of the brainstem, often the result of a thrombus or embolism. If a nutritional deficiency is causing your pica, treating it should ease your symptoms. Atnairp pica guide for professionals autism speaks. Published by the american psychiatric association apa, the diagnostic and statistical manual of mental disorders, 5th edition dsm5, is a tool that provides mental health professionals, with a common language to communicate more reliable mental health disorder diagnoses between professionals in other fields. Clinical presentation individuals with pica may consume an eclectic variety of substances, including mud, pottery, clay, and laundry starch.
It is a complex behavior that can present with any number of variations table 1, and multiple pica determinants range from demands of tradition and acquired tastes in the cultural context to presumptive neurobiological mechanisms eg, iron deficiency, cns. We report a patient who presented with a left lateral medullary ischemic stroke after aneurysm repair who subsequently. Persons with mental retardation may have pica because of an inability. Pica comes from the latin word for magpie, a bird which is known for indiscriminate eating. Pica often occurs in people with developmental disabilities such as autism and is considered a psychiatric condition in that context. Fact sheets for families pica university of california. The typical substances ingested tend to vary with age. Blood in the stool which may be a sign of an ulcer that developed from eating nonfood items. Lateral medullary syndrome is a neurological disorder causing a range of symptoms due to ischemia in the lateral part of the medulla oblongata in the brainstem. According to the national library of medicine pica disorder can be found in 10 percent to 32 percent of children between the ages of 1 and 6. Central alveolar hypoventilation disorders denote conditions resulting from underlying neurologic disorders affecting the sensors, the central controller, or the integration of those signals leading to insufficient ventilation and reduction in partial pressures of oxygen. It is a rare affection secondary to the accumulation of diverse natured foreign bodies inside the digestive tract and more especially at the. A psychiatric syndrome with surgical consequences oatext.
Lateral medullary syndrome, also known as wallenberg syndrome, is a clinical syndrome caused by an acute ischemic infarct of the lateral medulla oblongata. Lateral medullary syndrome radiology reference article. With edinger and gordon holmes, he described the avian brain. Wallenberg syndrome lateral medullary syndrome aka pica syndrome posterior inferior cerebellar artery syndrome constellation of neurologic symptoms due to injury to the lateral part of the medulla in the brain. Young kids often put nonfood items like grass or toys in their mouths because theyre curious about the world around them. Pica is a psychological disorder characterized by an appetite for substances that are largely. Up to one third of children ages 1 to 6 have these eating behaviors. Pica is a condition that has been prevalent among humans for centuries. Pica disorder project gutenberg selfpublishing ebooks. If pica is a way for a person to escape an activity or situation, the reason why the person wants to escape the activity should be examined and the person should be moved to a new situation. Pathologic and neuroradiologic findings have identified the causal lesion of. Fact sheets for families 0106 pica pica is the act of eating nonfood items. Pica is eating disorder it is abnormal and very misunderstood problem pica is defined as persistent compulsive bizarre craving abnormal appetite of, mouthing of or eating ingesting of nonfood clay, dirt, sand, stones, pebbles, hair, feces, lead, vinyl gloves, plastic, pencil erasers, fingernails, plaster, wax, paper, paint.