SICKLE CELL CRISIS PRESENTING AS A NUMB CHIN SYNDROME IN A CHILD
Bibliographic record
Abstract
Objectives: Numb chin syndrome, also called mental neuropathy, is usually conceived of as a harbinger of malignancy of the skull. We describe an unusual presentation of a case of a numb chin syndrome in a child with sickle cell crisis involving her mandible. Methods: Case report. Results: The patient is 6 year-old girl with known sickle cell disease and auto-immune hepatitis of unclear etiology. She was seen by the neurology service for acute onset of a numb chin in context of a painful jaw. Examination revealed painful swelling at the level of the mandible bilaterally as well as sensory deficits in the distribution of the mental nerve, involving the lower lip and chin bilaterally. Taste and tongue sensation were preserved. MRI of the jaw showed a right temporal mandibular joint effusion and abnormal marrow signal suggestive of vascular necrosis. Symptoms completely resolved after one week with symptomatic treatment of the sickle cell crisis. This patient is now followed for a steroid myopathy. Conclusion: Sickle cell crisis should be included in the differential diagnosis of numb chin syndrome in children. Magnetic Resonance Imaging is useful in identifying the underlying etiology.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".