: 6 Worldwide, it is estimated that 2.58% of adults have persistent ADHD (where the individual currently meets the criteria and there is evidence of childhood onset), and 6.76% of adults have symptomatic ADHD (meaning that they currently meet the criteria for ADHD, regardless of childhood onset). In 2020, this was 139.84 million and 366.33 million affected adults respectively. Around 15% of children with ADHD continue to meet full DSM-IV-TR criteria at 25 years of age, and 50% still experience some symptoms. : 2  As of 2010, most adults remain untreated. Many adults with ADHD without diagnosis and treatment have a disorganised life, and some use non-prescribed drugs or alcohol as a coping mechanism. Other problems may include relationship and job difficulties, and an increased risk of criminal activities. : 6  Associated mental health problems include depression, anxiety disorders, and learning disabilities.Some ADHD symptoms in adults differ from those seen in children. While children with ADHD may climb and run about excessively, adults may experience an inability to relax, or may talk excessively in social situations. : 6  Adults with ADHD may start relationships impulsively, display sensation-seeking behavior, and be short-tempered. : 6  Addictive behavior such as substance abuse and gambling are common. : 6  This led to those who presented differently as they aged having outgrown the DSM-IV criteria. : 5–6  The DSM-5 criteria does specifically deal with adults unlike that of DSM-IV, which does not fully take into account the differences in impairments seen in adulthood compared to childhood. : 5 For diagnosis in an adult, having symptoms since childhood is required.
Dysphagia lusoria (or Bayford-Autenrieth dysphagia) is an abnormal condition characterized by difficulty in swallowing caused by an aberrant right subclavian artery. It was discovered by David Bayford in 1761 and first reported in a paper by the same in 1787. Pathophysiology
During development of aortic arch, if the proximal portion of the right fourth arch disappears instead of distal portion, the right subclavian artery will arise as the last branch of aortic arch. It then courses behind the esophagus (or rarely in front of esophagus, or even in front of trachea) to supply blood to right arm. This causes pressure on esophagus and results in dysphagia. It can sometimes result in upper gastrointestinal tract bleeding. Investigation of choice - CT angiography

Treatment
Surgical repair is performed. Reconstruction or ligation of aberrant right subclavian artery by sternotomy/by neck approach. Eponym
David Bayford called it dysphagia lusoria because in Latin, lusus naturæ means sports of nature or natural anomaly. Bayford-Autenrieth dysphagia is eponym for Bayford and Autenrieth. See also
Aberrant subclavian artery
Ortners syndrome

References


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