Merck Manual

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Clinical Presentation and Medical Differentials for Compulsive Disorders

Clinical Presentation and Medical Differentials for Compulsive Disorders

Compulsive Disorder Signs

Medical Differentials

Diagnostic Tests / Therapeutic Trials

Ingestive: pica, licking, sucking, swallowing (glugging)

Polyphagia, polyuria, polydipsia

GI, food intolerance

Urogenital/renal, hepatic, endocrine

Endoscopy, food trial, steroid trial, GI protectants

Blood and urine testing, hormonal assays, modified water deprivation test

Dermatologic/self-trauma: nail biting, flank sucking, acral lick dermatitis, pyschogenic alopecia, tail mutilation

Atopic dermatitis, bacterial or parasitic hypersensitivity, adverse food reaction, parasite, infection, neuropathy, pain

Dermatologic tests (eg, skin scraping, trichogram, fungal culture, biopsy), therapeutic response trial

Neurologic: spinning, star gazing, pouncing, fly snapping, light or shadow chasing

Focal seizure, neuropathy

Neurologic tests (eg, MRI), therapeutic seizure therapy trial (eg, levetiracetam, potassium bromide, phenobarbital)