Inpatient Diagnosis and Management of Neuromuscular Disorders

2021 ◽  
Vol 41 (05) ◽  
pp. 493-510
Author(s):  
Leana Doherty ◽  
Vinay Chaudhry
Keyword(s):  
Pattern Recognition ◽  
Respiratory Failure ◽  
Neuromuscular Disorders ◽  
Outpatient Basis ◽  
Diagnostic Features ◽  
Clinical Pattern ◽  
Pathologic Features ◽  
Life Threatening ◽  
Neuromuscular Conditions ◽  
Anatomic Localization

AbstractAlthough many neuromuscular conditions are evaluated on an outpatient basis owing to their chronic or progressive nature, more urgent evaluation and management is often required for the inpatient presenting with acute to subacute focal or generalized numbness or weakness. This review focuses on clinical pattern recognition and basic anatomic localization principles to aid in the identification of common, as well as some less frequently encountered, neuromuscular disorders in hospitalized patients. The characteristic clinical and diagnostic features, associated complications, and recommended treatments of key neuromuscular conditions with acute and subacute manifestations are discussed. These conditions can be life-threatening in some cases, such as in Guillain–Barré syndrome, owing to associated oropharyngeal weakness, respiratory failure, or marked dysautonomia. Prompt recognition of the clinical and pathologic features is therefore necessary to reduce associated morbidity and mortality.

scholarly journals Asymptomatic mediastinal extra-adrenal paraganglioma as a cause of sudden death: a case Report

2019 ◽  
Vol 14 (1) ◽  
pp. 564-567
Author(s):  
Qiancheng Xu ◽  
Yingya Cao ◽  
Hongzhen Yin ◽  
Rongrong Wu ◽  
Tao Yu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Case Report ◽  
Respiratory Failure ◽  
Pressure Drop ◽  
Thoracic Cavity ◽  
Severe Hypotension ◽  
Life Threatening ◽  
History Of ◽  
Posterior Mediastinal ◽  
Extra Adrenal Paraganglioma

AbstractA 23-year-old female patient was referred for treatment of a posterior mediastinal tumour. There was no history of hypertension or headache and no other complaints. The patient’s blood pressure increased to 210/125 mmHg after surgically manipulating the tumour, subsequently reversing to severe hypotension (25/15 mmHg) immediately after the tumour was removed. The life-threatening and irreversible blood pressure drop was difficult to treat with fluid and vasopressors, and the patient ultimately died of cardio-respiratory failure. Asymptomatic paraganglioma can be non-functional but can also be fatal. For any lump in the thoracic cavity, paraganglioma should be ruled out.

Mediastinal teratoma presenting with respiratory distress and cardiogenic shock in a neonate

2020 ◽  
Vol 30 (5) ◽  
pp. 788-789
Author(s):  
Mila Stajevic ◽  
Ivan Dizdarevic ◽  
Igor Krunic ◽  
Vesna Topic
Keyword(s):  
Respiratory Failure ◽  
Cardiogenic Shock ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Distress Syndrome ◽  
Emergency Operation ◽  
Fast Growing ◽  
Mediastinal Teratoma ◽  
Venous Compression ◽  
Life Threatening

Abstract Mediastinal teratomas are uncommon, fast-growing thoracic tumours, which are usually diagnosed in childhood or adolescence. Neonatal forms are the rarest and often present with life-threatening respiratory distress syndrome. In our case, respiratory failure in a neonate was aggravated by severe cardiogenic shock due to aortic and systemic venous compression, extreme heart displacement and rotation, necessitating an emergency operation on the first day of life.

scholarly journals Role of SatO2, PaO2/FiO2 Ratio and PaO2 to Predict Adverse Outcome in COVID-19: A Retrospective, Cohort Study

2021 ◽  
Vol 18 (21) ◽  
pp. 11534
Author(s):  
Stefano Sartini ◽  
Laura Massobrio ◽  
Ombretta Cutuli ◽  
Paola Campodonico ◽  
Cristina Bernini ◽  
...  
Keyword(s):  
Respiratory Failure ◽  
Adverse Outcome ◽  
University Hospital ◽  
Rt Pcr ◽  
Threatening Condition ◽  
Life Threatening ◽  
Group A ◽  
Group B ◽  
The University

COVID-19 respiratory failure is a life-threatening condition. Oxygenation targets were evaluated in a non-ICU setting. In this retrospective, observational study, we enrolled all patients admitted to the University Hospital of Genoa, Italy, between 1 February and 31 May 2020 with an RT-PCR positive for SARS-CoV-2. PaO2, PaO2/FiO2 and SatO2% were collected and analyzed at time 0 and in case of admission, patients who required or not C-PAP (groups A and B) were categorized. Each measurement was correlated to adverse outcome. A total of 483 patients were enrolled, and 369 were admitted to hospital. Of these, 153 required C-PAP and 266 had an adverse outcome. Patients with PaO2 <60 and >100 had a higher rate of adverse outcome at time 0, in groups A and B (OR 2.52, 3.45, 2.01, respectively). About the PaO2/FiO2 ratio, the OR for < 300 was 3.10 at time 0, 4.01 in group A and 4.79 in group B. Similar odds were found for < 200 in any groups and < 100 except for group B (OR 11.57). SatO2 < 94% showed OR 1.34, 3.52 and 19.12 at time 0, in groups A and B, respectively. PaO2 < 60 and >100, SatO2 < 94% and PaO2/FiO2 ratio < 300 showed at least two- to three-fold correlation to adverse outcome. This may provide simple but clear targets for clinicians facing COVID-19 respiratory failure in a non ICU-setting.

scholarly journals A retrospective cohort study of idiopathic diaphragmatic palsy: a diagnostic triad, natural history and prognosis

2021 ◽  
pp. 00953-2020
Author(s):  
Syeda Nafisa ◽  
Ben Messer ◽  
Beatrice Downie ◽  
Patience Ehilawa ◽  
William Kinnear ◽  
...  
Keyword(s):  
Cohort Study ◽  
Respiratory Failure ◽  
Natural History ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Neuromuscular Disorders ◽  
Inspiratory Muscle ◽  
Diaphragmatic Palsy ◽  
Infection And Inflammation ◽  
Diaphragmatic Weakness

The diaphragm is the main inspiratory muscle, and diaphragmatic weakness can lead to respiratory failure. Diaphragmatic weakness or paralysis commonly presents in association with more generalised neuromuscular disorders. However, it can be caused by other pathologies, such as trauma, compression, infection and inflammation [1]. Isolated diaphragmatic palsy (DP) is well-described [2], but often missed in adults [3], especially in bilateral diaphragmatic palsy (BDP) where both domes of the diaphragm are elevated.

scholarly journals Suicide, the main cause of referral of patients from a general hospital for psychiatric evaluation

2021 ◽  
Vol 5 (1) ◽  
pp. 018-021
Author(s):  
Gómez Elena ◽  
Guzmán Marianela ◽  
Torres Oriol Yuguero
Keyword(s):  
Suicide Attempts ◽  
Hospital Admissions ◽  
Cross Sectional Study ◽  
Psychiatric Evaluation ◽  
Outpatient Basis ◽  
Test Results ◽  
Chi Square ◽  
Cross Sectional ◽  
Chi Square Test ◽  
Life Threatening

Introduction: Psychiatric emergencies constitute between 1% - 10% of general emergencies in Spain, of which a quarter will end up being hospital admissions. There is little literature on patients who are referred from general to specialized hospitals. Methods: Cross-Sectional study of all the patients referred in 2018. Sociodemographic variables and clinical variables, such as diagnosis and discharge destination, were analyzed. An analysis was performed by comparing means with the Chi Square test. Results: 433 derived emergencies were analyzed. Most of the patients were women. The main reason for derivation were suicide attempts. Of those patients, 40% required hospitalizations. More than 50% of the derived emergencies were referred to the home and followed up on an outpatient basis. Conclusion: Most derived emergencies are referred to the home after evaluation. This implies that most are not life-threatening and that with adequate tools for evaluating suicide risk, we could avoid transfers and improve the resolution of these cases.

scholarly journals A Case of a 34-Year-Old Female with Acute Hypoxemic Respiratory Failure and Proximal Muscle Weakness

2017 ◽  
Vol 2017 ◽  
pp. 1-3
Author(s):  
Alex Diaz ◽  
Surit Sharma
Keyword(s):  
Respiratory Failure ◽  
Muscle Weakness ◽  
Length Of Hospital Stay ◽  
Proximal Muscle Weakness ◽  
Proximal Muscle ◽  
Hypoxemic Respiratory Failure ◽  
Acute Hypoxemic Respiratory Failure ◽  
Wound Botulism ◽  
Life Threatening Illness ◽  
Life Threatening

Wound associated botulism is an unusual presentation. Early detection of this potentially life-threatening illness can significantly shorten length of hospital stay and improve prognosis. We present a case of a 34-year-old female with a history of heroin abuse who presented to the ED with acute respiratory failure, diplopia, and proximal muscle weakness. There was early concern for wound botulism as the instigating process. After discussion with the CDC, she was given equine serum heptavalent botulism antitoxin. Laboratory analysis later confirmed our suspicion. Symptoms improved and the patient was liberated from mechanical ventilation on day 14 and discharged from the hospital on day 23.

Techniques for Decomposition of EMG Signals

2011 ◽  
pp. 467-477
Author(s):  
Arun Kumar Wadhwani ◽  
Sulochana Wadhwani
Keyword(s):  
Pattern Recognition ◽  
Wavelet Transform ◽  
Muscle Fatigue ◽  
Cross Correlation ◽  
Neuromuscular Disorders ◽  
Clinical Importance ◽  
Neuromuscular Control ◽  
Diagnostic Information ◽  
Self Organizing Map ◽  
Statistical Pattern

The information extracted from the EMG recordings is of great clinical importance and is used for the diagnosis and treatment of neuromuscular disorders and to study muscle fatigue and neuromuscular control mechanism. Thus there is a necessity of efficient and effective techniques, which can clearly separate individual MUAPs from the complex EMG without loss of diagnostic information. This chapter deals with the techniques of decomposition based on statistical pattern recognition, cross-correlation, Kohonen self-organizing map and wavelet transform.

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