scholarly journals Status dystonicus: study of five cases

2005 ◽  
Vol 63 (1) ◽  
pp. 26-29 ◽  
Author(s):  
Hélio A.G. Teive ◽  
Renato P. Munhoz ◽  
Mônica M. Souza ◽  
Sérgio A. Antoniuk ◽  
Mara Lucia S.F. Santos ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Cerebral Palsy ◽  
Intensive Care ◽  
The Other ◽  
Neurosurgical Procedures ◽  
Segmental Dystonia ◽  
Status Dystonicus ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Status Dystonicus (SD) is characterized by generalized muscle contractions in dystonic patients. We report 5 cases of SD, two of which in patients with dystonic cerebral palsy, one in a patient with primary segmental dystonia, one in a patient with Hallervorden-Spatz syndrome and one in a patient with Wilson's disease (WD). Three patients were admitted to an intensive care unit and treated with propofol and midazolam, and two were submitted to neurosurgical procedures (bilateral pallidotomy and bilateral pallidal deep brain stimulation). Triggering factors were identified in three patients as follows: infection, stress-induced and zinc therapy for WD. On follow-up, two patients presented with significant improvement of dystonia, whereas the other three cases the clinical picture ultimately returned to baseline pre-SD condition.

Pallidal deep brain stimulation in patients with primary generalised or segmental dystonia: 5-year follow-up of a randomised trial

2012 ◽  
Vol 11 (12) ◽  
pp. 1029-1038 ◽  
Author(s):  
Jens Volkmann ◽  
Alexander Wolters ◽  
Andreas Kupsch ◽  
Jörg Müller ◽  
Andrea A Kühn ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Randomised Trial ◽  
Segmental Dystonia ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

Cerebral Palsy and the NICU Graduate

2002 ◽  
Vol 21 (1) ◽  
pp. 53-57 ◽  
Author(s):  
Jennifer McMurray ◽  
Martha Wilson Jones ◽  
Jamil Khan
Keyword(s):  
Intensive Care Unit ◽  
Cerebral Palsy ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Neonatal Intensive Care ◽  
Nursing School ◽  
Made In

PUT YOURSELF IN THIS SITUAtion. You have three drips to remix, your oscillator patient is starting to crash, and you have just been asked to work a double shift because the hospital is short staffed. The unit secretary informs you that the mother of one of your former primary patients is on the telephone and is hysterical. A physician at the neonatal follow-up clinic has just told her that her baby has cerebral palsy (CP). She wants reassurance, information, and input from you because you established a rapport with her when her infant was in the neonatal intensive care unit and she trusts you. You remember cerebral palsy from your pediatric rotation in nursing school, but you don’t see many actual diagnoses made in the NICU, and your recollection is foggy.

GNAO1 Mutation–Induced Pediatric Dystonic Storm Rescue With Pallidal Deep Brain Stimulation

2018 ◽  
Vol 33 (6) ◽  
pp. 413-416 ◽  
Author(s):  
C. Michael Honey ◽  
Armaan K. Malhotra ◽  
Maja Tarailo-Graovac ◽  
Clara D. M. van Karnebeek ◽  
Gabriella Horvath ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Deep Brain Stimulation ◽  
Intensive Care Unit Admission ◽  
Pediatric Intensive Care Unit ◽  
Brain Stimulation ◽  
De Novo ◽  
Pediatric Intensive Care ◽  
Status Dystonicus ◽  
Deep Brain

Dystonic storm or status dystonicus is a life-threatening hyperkinetic movement disorder with biochemical alterations due to the excessive muscle contractions. The medical management can require pediatric intensive care unit admission and a combination of medications while the underlying trigger is managed. Severe cases may require general anesthesia and paralytic agents with intubation and may relapse when these drugs are weaned. Deep brain stimulation of the globus pallidum has been reported to terminate dystonic storm in several pediatric cases. We present a 10-year-old boy with a de novo GNAO1 mutation–induced dystonic storm who required a 2-month pediatric intensive care unit admission and remained refractory to all medical treatments. Deep brain stimulation was performed under general anesthetic without complication. His dyskinetic movements stopped with initiation of stimulation. He was discharged from the pediatric intensive care unit after 4 days. We present prospectively evaluated changes in dystonia symptoms and quality of life for a patient with GNAO1 mutation treated with deep brain stimulation.

Tolerance of early pallidal stimulation in pediatric generalized dystonia

2013 ◽  
Vol 12 (5) ◽  
pp. 476-482 ◽  
Author(s):  
Yasushi Miyagi ◽  
Yu Koike
Keyword(s):  
Deep Brain Stimulation ◽  
The Other ◽  
Maturation Process ◽  
Patient Case ◽  
Pallidal Stimulation ◽  
Status Dystonicus ◽  
Generalized Dystonia ◽  
Electrical Stimuli ◽  
Pallidal Deep Brain Stimulation ◽  
Deep Brain

The authors report on 2 cases of pediatric generalized dystonia with a DYT1 mutation; the patients, an 11-year-old girl and a 9-year-old boy, underwent chronic, pallidal deep brain stimulation (DBS) of the globus pallidus internus (GPi). The dystonic postures in both cases showed dramatic improvements with pallidal DBS, but each patient's symptoms gradually recurred within a year, irrespective of exhaustive readjustments of the stimulation settings. After the recurrence of the dystonic symptoms, the DBS leads were replaced within the GPi in one patient (Case 1) and additional DBS leads were implanted into the bilateral subthalamic nuclei in the other patient (Case 2). Neither measure produced any further clinical benefit, and the patient in Case 2 died of status dystonicus 2 days after reoperation. These findings suggest that early pallidal DBS for pediatric dystonia is indeed effective, although there are some cases in which its therapeutic effect is lost. One possible reason may be the ability of the preadolescent brain to tolerate chronic electrical stimuli during the active maturation process.

scholarly journals Patent ductus arteriosus in preterm infants; experience of a tertiary referral neonatal intensive care unit: prevalence, complications, and management

2020 ◽  
Vol 68 (1) ◽  
Author(s):  
Reem M. Soliman ◽  
Fatma Alzahraah Mostafa ◽  
Antoine Abdelmassih ◽  
Elham Sultan ◽  
Dalia Mosallam
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Side Effects ◽  
Patent Ductus Arteriosus ◽  
Neonatal Intensive Care Unit ◽  
Preterm Infants ◽  
Neonatal Intensive Care ◽  
Ductus Arteriosus ◽  
Patent Ductus

Abstract Background Patent ductus arteriosus poses diagnostic and therapeutic dilemma for clinicians, diagnosis of persistent PDA, and determination of its clinical and hemodynamic significance are challenging. The aim of this study is to determine the prevalence of PDA in preterm infants admitted to our NICU, to report cardiac and respiratory complications of PDA, and to study the management strategies and their subsequent outcomes. Result Echocardiography was done for 152 preterm babies admitted to neonatal intensive care unit (NICU) on day 3 of life. Eighty-seven (57.2%) preterms had PDA; 54 (62.1%) non-hemodynamically significant PDA (non-hsPDA), and 33 (37.9%) hemodynamically significant PDA. Hemodynamically significant PDA received medical treatment (paracetamol 15 mg/kg/6 h IV for 3 days). Follow-up echocadiography was done on day 7 of life. Four babies died before echo was done on day 7. Twenty babies (68.9%) achieved closure after 1st paracetamol course. Nine babies received 2nd course paracetamol. Follow-up echo done on day 11 of life showed 4 (13.7%) babies achieved successful medical closure after 2nd paracetamol course; 5 babies failed closure and were assigned for surgical ligation. The group of non-hsPDA showed spontaneous closure after conservative treatment. Pulmonary hemorrhage was significantly higher in hsPDA group. Mortality was higher in hsPDA group than non-hsPDA group. Conclusion Echocardiographic evaluation should be done for all preterms suspected clinically of having PDA. We should not expose vulnerable population of preterm infants to medication with known side effects unnecessarily; we should limit medical closure of PDA to hsPDA. Paracetamol offers several important therapeutic advantages options being well tolerated and having more favorable side effects profile.

scholarly journals Comparison of three fixation methods for orotracheal intubation in 95 adults

2020 ◽  
Vol 25 (1) ◽  
Author(s):  
Ye Sun ◽  
Hua Fan ◽  
Xiao-Xia Song ◽  
Hua Zhang
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Tracheal Intubation ◽  
Older People ◽  
Endotracheal Intubation ◽  
Orotracheal Intubation ◽  
The Other ◽  
Fixation Methods ◽  
The Difference

Abstract Background The present study aimed to compare three fixation methods for orotracheal intubation. Methods Through literature retrieval, the effects of the adhesive/twill tape method, fixator method, and adhesive/twill tape–fixator alternation method on patients with tracheal intubation in the intensive care unit (ICU) were compared. Results The fixator and alternation methods were more effective in protecting the tongue mucosa and teeth. The alternation method was superior to the other two methods in maintaining the position of the endotracheal intubation. However, the difference in facial and lip injuries between the three methods was not statistically significant. Conclusion The fixator method can significantly reduce intraoral injury and is more suitable for older people with weak tongue mucosa and loose teeth. These are worth popularizing among a wider group.

A Mixed Methods Analysis of Parental Perspectives on Diagnosis and Prognosis of Neonatal Intensive Care Unit Graduates With Cerebral Palsy

2020 ◽  
Vol 35 (5) ◽  
pp. 336-343
Author(s):  
Katherine Guttmann ◽  
John Flibotte ◽  
Sara B. DeMauro ◽  
Holli Seitz
Keyword(s):  
Intensive Care Unit ◽  
Cerebral Palsy ◽  
Content Analysis ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Thematic Analysis ◽  
Neonatal Intensive Care ◽  
Free Text ◽  
Word Count ◽  
Linguistic Inquiry

This study aimed to evaluate how parents of former neonatal intensive care unit patients with cerebral palsy perceive prognostic discussions following neuroimaging. Parent members of a cerebral palsy support network described memories of prognostic discussions after neuroimaging in the neonatal intensive care unit. We analyzed responses using Linguistic Inquiry and Word Count, manual content analysis, and thematic analysis. In 2015, a total of 463 parents met eligibility criteria and 266 provided free-text responses. Linguistic Inquiry and Word Count analysis showed that responses following neuroimaging contained negative emotion. The most common components identified through the content analysis included outcome, uncertainty, hope/hopelessness, and weakness in communication. Thematic analysis revealed 3 themes: (1) Information, (2) Communication, and (3) Impact. Parents of children with cerebral palsy report weakness in communication relating to prognosis, which persists in parents’ memories. Prospective work to develop interventions to improve communication between parents and providers in the neonatal intensive care unit is necessary.

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