Transverse abdominal plane block for percutaneous gastrostomy in patient with amyotrophic lateral sclerosis

2017 ◽  
Author(s):  
VINCENZO Pota
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Percutaneous Gastrostomy ◽  
Lateral Sclerosis

scholarly journals Amyotrophic lateral sclerosis in Slovenia – analysis of patient population at the Ljubljana Institute of Clinical Neurophysiology

2015 ◽  
Vol 84 (7-8) ◽  
Author(s):  
Mojca Kirbiš ◽  
Blaž Koritnik ◽  
Lea Leonardis ◽  
Leja Dolenc Grošelj ◽  
Polona Klinar ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Clinical Neurophysiology ◽  
Tertiary Care ◽  
Disease Onset ◽  
Diagnostic Delay ◽  
Ventilatory Support ◽  
Percutaneous Gastrostomy ◽  
Non Invasive ◽  
Disease Characteristics ◽  
Lateral Sclerosis

Backgorund: Data on epidemiology and disease characteristics of amyotrophic lateral sclerosis (ALS) are geographically limited and no systematically collected data exist for slovenian patients. We performed a retrospective descriptive study on clinical attributes and disease course of patients with ALS treated at the Institute of clinical neurophysiology (ICN), University Medical Centre Ljubljana since the foundation of a specialised ALS group.Methods:  All 271 patients treated at ICN in the 10-year period between 2003 and 2012 were analysed. Data on basic demographic characteristics, phenotype of disease onset, diagnostic delay, survival, family history, use of percutaneous gastrostomy (PEG), of non-invasive ventilation and of riluzole were obtained.Results:  Mean age at symptoms onset was 62.7 ± 11.4 years, median diagnostic delay 11 (IQ range  7–19) months and mean survival from time of enrolment 16.4 ± 15.1 months.  179 (66.1%)patients had spinal onset disease and 71 (26.2%) bulbar onset disease. Factors associated with longer survival were lower age at enrolment, longer diagnostic delay and use of PEG. The proportion of patients using non-invasive ventilatory support was rising through the analysed years.Conclusions: Disease characteristics and survival in our series are similar to data from other tertiary care centres. The need for non-invasive ventilatory support in ALS patients is increasing.

CT fluoroscopy-guided percutaneous gastrostomy with loop gastropexy and peel-away sheath trocar technique in 31 amyotrophic lateral sclerosis patients

2012 ◽  
Vol 53 (3) ◽  
pp. 285-291 ◽  
Author(s):  
Maximilian de Bucourt ◽  
Federico Collettini ◽  
Christian E Althoff ◽  
Florian Streitparth ◽  
Johannes Greupner ◽  
...  
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Ct Fluoroscopy ◽  
Percutaneous Gastrostomy ◽  
Lateral Sclerosis

scholarly journals MAC Anesthesia during Endoscopic Percutaneous Gastrostomy (PEG) in a Patient with Amyotrophic Lateral Sclerosis (ALS). A Case Report.

2019 ◽  
Vol 3 (2) ◽  
Author(s):  
Majlinda Naço ◽  
Haxhire Gani ◽  
Arvin Dibra ◽  
Eden Naço ◽  
Suzana Mukaj
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Motor Neurons ◽  
The Body ◽  
Activity Level ◽  
Dose Titration ◽  
Body Parts ◽  
Noninvasive Blood Pressure ◽  
Percutaneous Gastrostomy ◽  
And Control ◽  
Lateral Sclerosis

Background: Amyotrophic lateral sclerosis (ALS) is a serious disease in which some brain and spinal cells die slowly. These nerve cells are called motor neurons and control the muscles that allow the body parts to move. Initially, the disease causes bodily fatigue and muscular weakness through degeneration of the upper and lower motor neurons, leading to loss of ability to initiate and control the voluntary bodily functions. In late stages this disease causes difficulty in the normal swelling and eating that causes the need for PEG in patients with ALS. This clinical picture increases the difficulty and the anesthetic risk used during the PEG application. Case presentation: We are describing our experience in a 56-year-old male patient, ASA III suffering from ALS and being admitted to our clinic to insert PEG. The patient presented BMI =15.6. After the patient provide informed consent, we were monitoring him for detect changes in pulse oximetry, noninvasive blood pressure, heart rate and visual assessment of ventilator activity, level of consciousness and discomfort. We used balanced propofol for moderate sedation (BPS), loading dose 1mg midazolam, 0.1 mg of fentanyl, and 5-15 mg propofol in smaller bolus dose were applied for more precise dose titration. The operation was performed after the patient lost the consciousness and had no pupil reflex. The EGD entered to the stomach. Fistula was localized after the visualization of light from the tube. Local lidocaine was applied and 1cm incision on the abdominal wall gave the possibility for application of fistula and gastro stoma placement. The patient wakes up 10 minutes after the end of the procedure without using antidotes. The patient after treatment went home in two days using gastro stoma for enteral feeding.

Automated Acoustic Analysis of Oral Diadochokinesis to Assess Bulbar Motor Involvement in Amyotrophic Lateral Sclerosis

2020 ◽  
Vol 63 (1) ◽  
pp. 59-73 ◽  
Author(s):  
Panying Rong
Keyword(s):  
Amyotrophic Lateral Sclerosis ◽  
Acoustic Analysis ◽  
Speaking Rate ◽  
Disease Stage ◽  
Healthy Controls ◽  
Tongue Movement ◽  
Major Barrier ◽  
Syllable Repetition ◽  
Oral Diadochokinesis ◽  
Lateral Sclerosis

Purpose The purpose of this article was to validate a novel acoustic analysis of oral diadochokinesis (DDK) in assessing bulbar motor involvement in amyotrophic lateral sclerosis (ALS). Method An automated acoustic DDK analysis was developed, which filtered out the voice features and extracted the envelope of the acoustic waveform reflecting the temporal pattern of syllable repetitions during an oral DDK task (i.e., repetitions of /tɑ/ at the maximum rate on 1 breath). Cycle-to-cycle temporal variability (cTV) of envelope fluctuations and syllable repetition rate (sylRate) were derived from the envelope and validated against 2 kinematic measures, which are tongue movement jitter (movJitter) and alternating tongue movement rate (AMR) during the DDK task, in 16 individuals with bulbar ALS and 18 healthy controls. After the validation, cTV, sylRate, movJitter, and AMR, along with an established clinical speech measure, that is, speaking rate (SR), were compared in their ability to (a) differentiate individuals with ALS from healthy controls and (b) detect early-stage bulbar declines in ALS. Results cTV and sylRate were significantly correlated with movJitter and AMR, respectively, across individuals with ALS and healthy controls, confirming the validity of the acoustic DDK analysis in extracting the temporal DDK pattern. Among all the acoustic and kinematic DDK measures, cTV showed the highest diagnostic accuracy (i.e., 0.87) with 80% sensitivity and 94% specificity in differentiating individuals with ALS from healthy controls, which outperformed the SR measure. Moreover, cTV showed a large increase during the early disease stage, which preceded the decline of SR. Conclusions This study provided preliminary validation of a novel automated acoustic DDK analysis in extracting a useful measure, namely, cTV, for early detection of bulbar ALS. This analysis overcame a major barrier in the existing acoustic DDK analysis, which is continuous voicing between syllables that interferes with syllable structures. This approach has potential clinical applications as a novel bulbar assessment.

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