Benzodiazepine Withdrawal Reaction in Two Children following Discontinuation of Sedation with Midazolam

1993 ◽  
Vol 27 (5) ◽  
pp. 579-581 ◽  
Author(s):  
Baziel G.M. van Engelen ◽  
Jules S. Gimbrere ◽  
Leo H. Booy
Keyword(s):  
Young Children ◽  
Case Reports ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Constant Infusion ◽  
Withdrawal Reaction ◽  
Very Young Children ◽  
Abrupt Discontinuation ◽  
Term Administration ◽  
Benzodiazepine Withdrawal

OBJECTIVE: To report the occurrence of recurrent benzodiazepine withdrawal reactions in two very young children following discontinuation of sedation with midazolam. CASE SUMMARY: A 15-month-old boy with apneic episodes was sedated with midazolam for 12 days with constant infusion. Half a day after discontinuation of the midazolam the boy became restless, tachycardic, and hyperpyrexia. When midazolam was readministered, all symptoms disappeared. Four days later midazolam was again discontinued and within 12 hours the same signs and symptoms reappeared. Midazolam infusion was restarted, and the signs and symptoms disappeared for the second time. After thoracotomy, a 14-day-old boy received intravenous midazolam for sedation for 29 days. Within 12 hours after discontinuation of midazolam he became restless, developed a bulging stomach secondary to aerophagia, and was vomiting. Midazolam therapy was reinstituted and continued for another 2 months by constant infusion. Thereafter, the boy was successfully weaned from artificial ventilation in 5 days under sedation with midazolam. About 12 hours after discontinuation of midazolam the boy became restless, tachycardic, again developed a bulging stomach because of aerophagia, and vomited. When the child was sedated with clorazepate by continuous infusion, the signs and symptoms disappeared. DISCUSSION: Case reports describing benzodiazepine withdrawal reaction upon discontinuation of midazolam were reviewed and compared. The symptoms observed in the children we present resemble those mentioned in the three children and two adults reported previously. Unique in the very young children in this article is the occurrence of gastrointestinal symptoms, which most likely are the result of air being swallowed secondary to severe agitation. CONCLUSIONS: Midazolam withdrawal reactions in adults and children, particularly in an intensive care unit, can be significant. Considerable caution must be taken with relatively long-term administration and abrupt discontinuation of midazolam.

scholarly journals Generalized Anxiety Disorder in Very Young Children: First Case Reports on Stability and Developmental Considerations

2018 ◽  
Vol 2018 ◽  
pp. 1-5
Author(s):  
Michael S. Scheeringa ◽  
Lauren C. Burns
Keyword(s):  
Anxiety Disorder ◽  
Young Children ◽  
Diagnostic Criteria ◽  
Generalized Anxiety Disorder ◽  
Emotional Processing ◽  
Case Reports ◽  
Future Research ◽  
Generalized Anxiety ◽  
Very Young Children ◽  
First Case

Generalized anxiety disorder (GAD) is purported to start in early childhood but concerns about attenuation of anxiety symptoms over time and the development of emerging cognitive and emotional processing capabilities pose multiple challenges for accurate detection. This paper presents the first known case reports of very young children with GAD to examine these developmental challenges at the item level. Three children, five-to-six years of age, were assessed with the Diagnostic Infant and Preschool Assessment twice in a test-retest reliability study. One case appeared to show attenuation of the worries during the test-retest period based on caregiver report but not when followed over two years. The other two cases showed stability of the full complement of diagnostic criteria. The cases were useful for demonstrating that the current diagnostic criteria appear adequate for this developmental period. The challenges of accurate assessment of young children that might cause missed diagnoses are discussed. Future research on the underlying dysregulation of negative emotionality and long-term follow-ups are needed to better understand the etiology, treatment, and course of GAD in this age group.

Systemic Lupus Erythematosus with Secondary Thrombotic Thrombocytopenic Purpura and Acute Parkinsonism: A Case Report

2022 ◽  
Vol 71 (12) ◽  
Author(s):  
Pooja Deepak ◽  
Roha Saeed Memon ◽  
Fizza Tariq ◽  
Hassan Ahmed ◽  
Shaheen Bhatti
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Thrombotic Thrombocytopenic Purpura ◽  
Lupus Erythematosus ◽  
Late Onset ◽  
Case Reports ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Urgent Care ◽  
Systemic Lupus ◽  
Thrombocytopenic Purpura

Systemic lupus erythematosus (SLE) is an autoimmune disease that has certain characteristic features but can also present with misleading signs and symptoms especially when it is of late-onset. Various case reports address its association with thrombotic thrombocytopenic purpura (TTP), however, its association with parkinsonism remains unclear. We present the case of a 58-year-old male who reported with acute-onset parkinsonism along with some gastrointestinal symptoms. Detailed laboratory investigations unmasked the underlying SLE with an overlapping picture of TTP. This unusual presentation in a resource-constrained setting created challenges and subsequent delays in the diagnosis and management of the patient. Despite urgent care, the patient’s age, presence of overlapping conditions, and multi-organ involvement were some of the factors due to which the treatment failed and he could not survive. We report the association of SLE with secondary TTP and parkinsonism.

Change and Recovery: Culturally Appropriate Early Childhood Programmes with Refugee Families and Communities

2015 ◽  
Vol 40 (3) ◽  
pp. 195-204 ◽  
Author(s):  
R. G. Signorelli ◽  
M. Coello ◽  
S. Momartin
Keyword(s):  
Early Childhood ◽  
Young Children ◽  
Help Seeking ◽  
Current Knowledge ◽  
Community Based Participatory Research ◽  
Signs And Symptoms ◽  
Cultural Transition ◽  
Culturally Appropriate ◽  
Refugee Families ◽  
Very Young Children

The STARTTerS Early Childhood Programme at the NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS) has been developed in response to the complex refugee experiences of very young children, their families and communities. This biopsychosocial and systemic model is informed by neuroscience, attachment theory and current knowledge of the nature and impact of refugee-specific trauma on very young children and their families. It addresses the complex interactions between, social, cultural and political factors within the trauma and recovery environments, as they influence the clients’ presentations and the choice of interventions with families in cultural transition (FICT).This paper provides a background to the STARTTerS programme, and reports on the results of a Community Based Participatory Research (CBPR) project with the Karen and Mandaean refugee communities. It explores perceptions and cultural views of signs and symptoms related to early childhood trauma. It also explores help seeking preferences in relation to the recovery, settlement and health needs of families with young children. This research has led to ongoing collaborative and consultative processes with those communities, resulting in the development of services and referral systems, which will build a comprehensive and culturally appropriate early childhood programme.

Acute Ethanol Intoxication in a Child

PEDIATRICS ◽  
1968 ◽  
Vol 42 (5) ◽  
pp. 837-840
Author(s):  
Joseph D. Dickerman ◽  
William Bishop ◽  
James F. Marks
Keyword(s):  
Young Children ◽  
Case Reports ◽  
Signs And Symptoms ◽  
Acute Poisoning ◽  
The Body ◽  
Ethanol Intoxication ◽  
Metabolic Fate ◽  
Acute Ethanol ◽  
Acute Ethanol Intoxication ◽  
Acute Alcoholism

Acute alcoholism is an important cause of morbidity and mortality in adults. The signs and symptoms of acute ethanol intoxication and the metabolic fate of ethanol in the body are well known.1 There are a few case reports of alcohol-induced hypoglycemia in young children2 and also case reports of withdrawal symptoms in infants of alcoholic mothers.3 Yet there is very little in the literature on the course, treatment, and prognosis of children with acute poisoning due to accidental alcohol ingestion. This report is designed to call attention to this entity, to describe a case whose blood alcoholic level was, as far as we know, the highest recorded in the pediatric literature in a survivor, to Suggest a mode of therapy, and, hopefully, to awaken pediatricians to thew possibility of ethanol intoxication in young children.

Intoxication from Accidental Marijuana Ingestion

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 848-850
Author(s):  
DIANA WEINBERG ◽  
ARTHUR LANDE ◽  
NANCY HILTON ◽  
DAVID L. KERNS
Keyword(s):  
Young Children ◽  
Adverse Effects ◽  
Adverse Reactions ◽  
Case Reports ◽  
Oral Ingestion ◽  
Ataxic Gait ◽  
White Girl ◽  
Very Young Children ◽  
Adolescents And Adults ◽  
Short Time

The increasing availability and use of marijuana in children, adolescents, and adults have been well documented in recent years. Adverse reactions have been described in adults who absorb the drug via inhalation or by oral and intravenous routes.1-5 To our knowledge, no cases of oral intoxication in very young children have been reported in the pediatric literature. We describe the adverse effects experienced by three children after an accidental oral ingestion of marijuana. CASE REPORTS Case 1 J.H., a 3-year-old previously healthy, white girl, was noted by her baby-sitter to be behaving abnormally a short time after lunch. Approximately two hours later, her mother observed the child to have an ataxic gait and a voracious appetite.

Grandparents Reveal Their Secrets: A New Holocaust Narrative for the Young ‘Third Generation’ in Israel

2012 ◽  
Vol 5 (1) ◽  
pp. 97-110 ◽  
Author(s):  
Yael Darr
Keyword(s):  
Young Children ◽  
First Generation ◽  
Third Generation ◽  
Master Narrative ◽  
Safe Distance ◽  
Domestic Sphere ◽  
Holocaust Memory ◽  
Very Young Children ◽  
The Holocaust ◽  
New Type

Since the 1990s, a new type of Holocaust story has been emerging in Israeli children's literature. This new narrative is directed towards very young children, from preschool to the first years of elementary school, and its official goal is to instil in them an authentic ‘first Holocaust memory’. This essay presents the literary characteristics of this new Holocaust narrative for children and its master narrative. It brings into light a new profile of both writers and readers. The writers were young children during the Holocaust, and first chose to tell their stories from the safe distance of three generations. The readers are their grand-children and their grand-children's peers, who are assigned an essential role as listeners. These generational roles – the roles of a First Generation of writers and of a Third Generation of readers – are intrinsically familial ones. As such, they mark a significant change in the profile of yet another important figure in the Israeli intergenerational Holocaust discourse, the agent of the Holocaust story for children. Due to the new literary initiatives, the task of providing young children with a ‘first Holocaust memory’ is transferred from the educational authority, where it used to reside, to the domestic sphere.

Sign in / Sign up

Export Citation Format

Share Document