How do the clinical features of XXXX in childhood progress before diagnosis?

@entity1 @entity129 @entity1313 @entity428 @entity5 @entity391 @entity10
OBJECTIVES: To investigate the progression of the clinical features from symptom onset to diagnosis in @entity1 with @entity1313 . DESIGN: Retrospective case note review. @entity1 : Sixty @entity1 with @entity1313 : 27 @entity1 from Nagoya University Hospital diagnosed between February 2004 and April 2008, and 33 @entity1 from Anjo Kosei Hospital diagnosed between April 1995 and December 2008. RESULTS: Various symptoms and signs were observed. The most common initial symptoms or signs were @entity391 (24.1%), @entity10 (17.2%), unsteadiness (10.3%), and paresis (10.3%). Sixteen @entity1 were diagnosed based on the initial symptom or sign alone; six, at routine medical check-ups or had perinatal diagnosis; and the remaining 38, based on one or more additional features following the initial symptom. Nine of the 10 @entity1 with @entity10 as the initial symptom subsequently developed either @entity391 (in seven) or unsteadiness with @entity129 (in two). Twelve of the 14 @entity1 with @entity391 as the initial symptom subsequently developed @entity10 (in three), unsteadiness (in five), or other manifestations of @entity428 (in four). The remaining 14 had varied initial symptoms and combinations of symptoms and signs associated with the @entity5 location. The median pre-diagnosis symptomatic interval was 20.5 days. There was no significant difference in the median symptomatic interval between @entity1 with @entity10 or @entity391 as the initial symptom and those with any neurological sign. CONCLUSION: @entity1313 present with various initial symptoms and signs. Many are diagnosed as additional symptoms or signs develop. The clinical features exhibit several patterns of progression, which are related to the @entity5 location.
