Vestibular Pathology Presenting as Behavioral Problems in a Child With Down Syndrome: A Case Report
Bibliographic record
Abstract
Here we present a case of superior semicircular canal dehiscence (SSCD) in a non-verbal 17-year-old male patient with trisomy 21 that presented with behavioral problems, instead of the more typical symptoms of episodic noise-induced vertigo. SSCD syndrome is characterized by sound-, or pressure-induced vertigo. Patients often complain of vertigo or oscillopsia evoked by loud noises, which may be either external sounds or those elicited by the patients themselves when they are speaking. In cases of SSCD, auditory testing will typically reveal a conductive hearing loss on the affected side while high-resolution temporal bone computed-tomography will demonstrate bony dehiscence overlying the ipsilateral superior semicircular canal. Here we present a report of SSCD in a patient with Down Syndrome who was without speech and reacted to noise stimulation with behavioral outbursts. In this case, simple modifications, such as noise avoidance and hearing protection were able to effect positive changes in behavior and improve social interactions. This case underscores the importance of a broad differential diagnosis, and the need to consider alternate presentations, in children with Down Syndrome or any child who is otherwise unable to express himself.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".