The evaluation and management of an incessantly crying infant

Excessive Cry in a 5-Month-Old Infant Possibly due to Abdominal Epilepsy

“…Arumugam et al observed that paroxysmal crying episodes in an otherwise healthy infant younger than 4 months of age typically occurring in the late afternoon and evening suggest infantile colic. 4 However, by definition, the infant's age should be younger than 4 months to qualify as infantile colic, according to Rome III criteria (criteria set by the Rome foundation to diagnose functional gastrointestinal disorders). 5 Gastroesophageal reflux disease (GERD), diaper rash, cow's milk allergy, Diphtheria Tetanus Pertussis (DTP) immunization, insect bites, lactose overload/malabsorption (there should be accompanying frothy watery diarrhea with perianal excoriation), hunger, excessive tiredness and difficulties with breast feeding, viral illness, nonaccidental trauma, acute otitis media, urinary tract infection, meningitis, herpes infection, pneumonia, cellulitis, septic arthritis, osteomyelitis, tourniquet entrapment of digits and penis, corneal abrasions, ocular foreign body, retinal hemorrhage, retinal detachment, glaucoma, torsion of testis, urinary retention, obstructed inguinal and femoral hernia, constipation with or without anal fissure, intussusception, intestinal obstruction, foreign body in airway, supraventricular tachycardia, burns, sickle cell anemia crisis, pseudotumor cerebri, electrolyte, and acid-base imbalance are most of the various causes of excessive cry in infants, as found by us upon extensive search of the literature.…”

“…5 Gastroesophageal reflux disease (GERD), diaper rash, cow's milk allergy, Diphtheria Tetanus Pertussis (DTP) immunization, insect bites, lactose overload/malabsorption (there should be accompanying frothy watery diarrhea with perianal excoriation), hunger, excessive tiredness and difficulties with breast feeding, viral illness, nonaccidental trauma, acute otitis media, urinary tract infection, meningitis, herpes infection, pneumonia, cellulitis, septic arthritis, osteomyelitis, tourniquet entrapment of digits and penis, corneal abrasions, ocular foreign body, retinal hemorrhage, retinal detachment, glaucoma, torsion of testis, urinary retention, obstructed inguinal and femoral hernia, constipation with or without anal fissure, intussusception, intestinal obstruction, foreign body in airway, supraventricular tachycardia, burns, sickle cell anemia crisis, pseudotumor cerebri, electrolyte, and acid-base imbalance are most of the various causes of excessive cry in infants, as found by us upon extensive search of the literature. 4,6 However, none of the earlier problems explains the paroxysmal nature of crying every day afternoon to evening, followed by falling asleep, persisting for 1.5 months duration in an otherwise healthy and playful infant of 5 months of age. As mentioned earlier, infant was exclusively breast fed and had no cow's milk exposure.…”