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https://www.readbyqxmd.com/read/27931774/neonatal-venlafaxine-discontinuation-syndrome-a-mini-review
#1
REVIEW
Jonathon Holland, Richard Brown
During pregnancy, the developing fetal brain may be exposed to a range of psychotropic medications. The serotonin-noradrenergic reuptake inhibitor venlafaxine is one such drug, when used as a maternal antidepressant. Here we review the discontinuation phenomenon that may follow in exposed neonates following birth. Adults who abruptly stop taking venlafaxine can experience withdrawal symptoms. Venlafaxine and its metabolites cross the placenta and so the newborn can be exposed to this risk, as well as potential toxicity...
November 25, 2016: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/27931082/pharmacotherapeutic-considerations-for-individuals-with-down-syndrome
#2
Erik J Hefti, Javier G Blanco
Down syndrome (DS, trisomy 21) is the most common survivable disorder due to aneuploidy. Individuals with DS may experience multiple comorbid health problems including congenital heart defects, endocrine abnormalities, skin and dental problems, seizure disorders, leukemia, dementia, and obesity. These associated conditions may necessitate pharmacotherapeutic management with various drugs. The complex pathobiology of DS may alter drug disposition and drug response in some individuals. For example, reports have documented increased rates of adverse drug reactions in patients with DS treated for leukemia and dementia...
December 8, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27930967/epidemiology-and-diagnostic-and-therapeutic-management-of-febrile-seizures-in-the-italian-pediatric-emergency-departments-a-prospective-observational-study
#3
Giovanna Vitaliti, Emanuele Castagno, Fulvio Ricceri, Antonio Urbino, Alberto Verrotti Di Pianella, Riccardo Lubrano, Elisa Caramaschi, Maurizio Prota, Rita Maria Pulvirenti, Patrizia Ajovalasit, Giuseppe Signorile, Carla Navone, Maria Rosaria La Bianca, Alberto Villani, Giovanni Corsello, Raffaele Falsaperla
AIM: Febrile seizures (FS) involve 2-5% of the paediatric population, among which Complex FS (CFS) account for one third of accesses for FS in Emergency Departments (EDs). The aim of our study was to define the epidemiology, the clinical, diagnostic and therapeutic approach to FS and CFSs in the Italian EDs. METHODS: A multicenter prospective observational study was performed between April 2014 and March 2015. Patients between 1 and 60 months of age, randomly accessing to ED for ongoing FS or reported FS at home were included...
November 16, 2016: Epilepsy Research
https://www.readbyqxmd.com/read/27923222/pediatric-primary-diffuse-leptomeningeal-primitive-neuroectodermal-tumor-a-case-report-and-literature-review
#4
Jesna Mathew Sublett, Caitlin Davenport, Howard Eisenbrock, Shamsher Dalal, Syed A Jaffar Kazmi, Amir Kershenovich
BACKGROUND: Primary diffuse leptomeningeal primitive neuroectodermal tumor (PDL PNET) is extremely rare, with only 19 cases reported in the literature to date. We present a case of a child with rapidly progressive PDL PNET and a literature review. A 10-year-old boy presented with mood lability, hallucinations, generalized pain, enuresis, and headaches. Initial investigation failed to produce a diagnosis. The symptoms progressed to seizure, back pain, and papilledema. Imaging showed acute hydrocephalus and mild diffuse leptomeningeal enhancement without an identifiable primary lesion...
December 7, 2016: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/27923157/adjuvant-neuronal-nitric-oxide-synthase-inhibition-for-combined-treatment-of-epilepsy-and-comorbid-depression
#5
Tanveer Singh, Rajesh Kumar Goel
BACKGROUND: Elevated nitric oxide (NO) levels in the brain have been apparently associated with depression in kindled animals. Owing to the major role of neuronal nitric oxide synthase (nNOS) in brain and ineffectiveness of antiepileptic drugs (AEDs) in restoring nitrosative stress, the present study was envisaged to evaluate the adjuvant nNOS inhibitor, 7-nitroindazole (7-NI) with valproic acid for combined treatment of epilepsy and associated depression. METHODS: Pentylenetetrazole kindled animals associated with depression were treated with vehicle, valproate (300mg/kg/day ip), valproate with 7-NI (10mg/kg; 20mg/kg; 40mg/kg)/day ip and 7-NI (40mg/kg/day ip) for 15days...
October 4, 2016: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/27920872/anterior-and-posterior-suprasellar-extensions-of-a-symmetrical-trilobed-nonfunctional-giant-pituitary-adenoma-in-the-sagittal-plane-a-case-report-and-review-of-literature
#6
Rushabh M Vakharia, Roman Kremen, Ajit Vakharia, Obed Adarkwah, Gordon Anderson
INTRODUCTION: To the best of our knowledge, the presence of a trilobed nonfunctional giant pituitary adenoma has never been described before in the literature. These tumors present unique diagnostic and therapeutic challenges. Tumors of this etiology can be managed with pharmacologic treatment or aggressive surgical intervention. The following case illustrates an unique visual presentation of a giant pituitary adenoma. CASE PRESENTATION: We report the case of a 40-year-old Hispanic man who presented with new onset seizures...
December 2016: Radiology case reports
https://www.readbyqxmd.com/read/27920021/venous-and-arterial-air-embolism-a-rare-phenomenon-with-fatal-consequences
#7
Jatan Shah, Nasheena Jiwa, Natasha Mamdani, David Hill
Air embolism is often an iatrogenic complication which may occur in venous or arterial circulation depending on the port of entry. We present two cases in which air embolism occurred in venous and arterial circulation after contrast medium injection (CMI) and coronary artery bypass graft (CABG) surgery, respectively. In one case, accumulation of air bubbles was observed in the pulmonary artery after CMI. This was attributed to inadvertent injection of air owing to improper connection of the injector and the catheter...
December 5, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#8
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918326/anesthetic-considerations-for-patients-with-congenital-central-hypoventilation-syndrome-a-systematic-review-of-the-literature
#9
Saptashree M Basu, Frances F Chung, Shireen F AbdelHakim, Jean Wong
Congenital central hypoventilation syndrome (CCHS) is a form of sleep-disordered breathing characterized by a diminished drive to breathe during sleep, despite progressive hypercapnia and hypoxia. The condition results from mutations in the paired-like homeobox 2B (PHOX2B) gene. The aim of this review was to conduct a systematic search of the current data on CCHS as it relates to perioperative considerations and to discuss the classification, prevalence, pathophysiology, presentation, genetics, and management of the condition...
December 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27916439/adult-supratentorial-primitive-neuroectodermal-tumour-presenting-as-intracranial-haemorrhage-case-report
#10
Sean P Black-Tiong, Simon J I Sandler, Sophia Otto, Adam J Wells
Primitive neuroectodermal tumours (PNET) are highly malignant tumours with an aggressive clinical behaviour. Commonly seen in children, they are uncommon in the adult population, and rare in the supratentorial location. Adult supratentorial PNETs (ST-PNET) typically present with symptoms relating to raised intracranial pressure, seizures, or focal neurological deficits. Presentation with intracranial haemorrhage has been reported only twice before in the literature, one of which was fatal. We report the case of intracranial haemorrhage secondary to ST-PNET in a young adult and her immediate management...
December 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/27909631/a-nonoperative-approach-for-neurosurgical-management-of-a-sylvian-fissure-dermoid-cyst
#11
Ali S Haider, Clarence Kee, Danielle L DeBacker, Ian T Watson, Eliel N Arrey, Tijani Osumah, Dean Leonard, Chen Chen, Maryam Alam, L Gerard Toussaint Iii
The nonoperative management of sylvian fissure dermoid/epidermoid cysts presents a risk that is difficult to quantify. With rupture, potentially fatal complications such as chemical meningitis, hydrocephalus, fever, seizure, or meningeal irritation may occur. In this paper, we present an asymptomatic case of such a cyst with imaging evidence of prior rupture, and we review the literature for the likelihood of future complications. We use for illustration a case of a 68-year-old woman with imaging features of a sylvian fissure epithelial inclusion cyst who refused surgical intervention and review the literature for further investigation...
October 24, 2016: Curēus
https://www.readbyqxmd.com/read/27907964/critical-care-neurology-perspective-on-delirium
#12
Matthew B Maas, Andrew M Naidech
The evidence linking delirium to poor outcomes after critical illness is compelling, including higher mortality, prolonged mechanical ventilation, longer length of intensive care unit stay, and long-term cognitive impairments. The attitude toward delirium in the neurologic community is shifting away from viewing it as an unmodifiable, inevitable consequence of severe illness to treating it is as a neurologic emergency, akin to seizures or encephalitis. Delirium, like other manifestations of critical illness encephalopathy, is an organ dysfunction syndrome...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907958/critical-care-management-after-cardiac-arrest
#13
Hans Friberg, Tobias Cronberg
Sudden cardiac arrest is a devastating event with high mortality and substantial morbidity among survivors. Early recognition and intervention to restore circulation is the primary goal; once that is achieved, the path toward a meaningful recovery starts. Initial in-hospital care is focused on emergency cardiac care, but soon there is a change to a more brain-oriented critical care including targeted temperature management, brain monitoring, sedation, and repeated neurologic assessments. In patients who show early signs of awakening from coma once sedation has been stopped, the prognosis is generally good...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27907953/management-of-the-pediatric-neurocritical-care-patient
#14
Christopher M Horvat, Haifa Mtaweh, Michael J Bell
Pediatric neurocritical care is a growing subspecialty of pediatric intensive care that focuses on the management of acute neurological diseases in children. A brief history of the field of pediatric neurocritical care is provided. Neuromonitoring strategies for children are reviewed. Management of major categories of acute childhood central neurologic diseases are reviewed, including treatment of diseases associated with intracranial hypertension, seizures and status epilepticus, stroke, central nervous system infection and inflammation, and hypoxic-ischemic injury...
December 2016: Seminars in Neurology
https://www.readbyqxmd.com/read/27905264/biotin-thiamine-responsive-basal-ganglia-disease-catastrophic-consequences-of-delay-in-diagnosis-and-treatment
#15
Hussein Algahtani, Saeed Ghamdi, Bader Shirah, Bader Alharbi, Raghad Algahtani, Abdulrahman Bazaid
BACKGROUND: Biotin-thiamine-responsive basal ganglia disease (BTBGD) is an autosomal recessive neurometabolic disorder caused by mutations in the SLC19A3 gene. The disease is characterized by subacute encephalopathy with confusion, dysphagia, dysarthria, and seizures. METHODS: We diagnosed a family affected by BTBGD and studied them including prognosis of cases when diagnosed and treated early in the disease process. We also review the literature comprehensively and summarize all published data about this disorder...
December 1, 2016: Neurological Research
https://www.readbyqxmd.com/read/27896927/a-retrospective-review-of-anesthesia-and-perioperative-care-in-children-with-medium-chain-acyl-coa-dehydrogenase-deficiency
#16
Claire Allen, Russell Perkins, Bernd Schwahn
BACKGROUND: Medium-chain acyl-CoA dehydrogenase deficiency is the most common genetically determined disorder of mitochondrial fatty acid oxidation. Decompensation can result in hypoglycemia, seizures, coma, and death but may be prevented by ensuring glycogen stores do not become depleted. Perioperative care is of interest as surgery, fasting, and infection may all trigger decompensation and the safety of anesthetic agents has been questioned. Current guidelines from the British Inherited Metabolic Disease Group advise on administering fluid containing 10% glucose during the perioperative period...
November 29, 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#17
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27896903/imaging-diagnosis-magnetic-resonance-imaging-of-a-neuronal-heterotopia-in-the-brain-of-a-cat
#18
Antonia DeJesus, Bradley J Turek, Evelyn Galban, Jantra Ngosuwan Suran
A domestic shorthair kitten was presented for evaluation and further treatment of seizures. Magnetic resonance imaging of the brain revealed a large multilobulated mass in the third ventricle extending into the right lateral ventricle with secondary obstructive hydrocephalus. The mass was homogeneously isointense to gray matter on T2W, T2-FLAIR, T2(*) W, T1W, and ADC images, and hyperintense on DW-EPI. There was no appreciable contrast enhancement. Seizures were managed medically and with subsequent ventriculoperitoneal shunt placement...
November 28, 2016: Veterinary Radiology & Ultrasound
https://www.readbyqxmd.com/read/27895691/prognostic-factors-of-neurological-outcomes-in-late-preterm-and-term-infants-with-perinatal-asphyxia
#19
Sun Young Seo, Gyu Hong Shim, Myoung Jae Chey, Su Jeong You
PURPOSE: This study aimed to identify prognostic factors of neurological outcomes, including developmental delay, cerebral palsy and epilepsy in late-preterm and term infants with perinatal asphyxia. METHODS: All late-preterm and term infants with perinatal asphyxia or hypoxic-ischemic insults who admitted the neonatal intensive care unit of Inje University Sanggye Paik Hospital between 2006 and 2014 and were followed up for at least 2 years were included in this retrospective study...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27895359/awake-craniotomy-for-brain-tumours-in-pakistan-an-initial-case-series-from-a-developing-country
#20
Saad Akhtar Khan, Karim Rizwan Nathani, Badar Uddin Ujjan, Muhammad Danish Barakzai, Syed Ather Enam, Faraz Shafiq
Awake craniotomy offers safe resection of brain tumours in eloquent area. Aga Khan University Hospital, Karachi, recently started the programme in Pakistan, and the current study was planned to assess our experience of the first 16 procedures. The retrospective study comprised all such procedures done from November 2015 to May 2016. Pre-operative and post-operative variables were analysed. Of the 16 patients, 11(68.75%) were males and 5(31.25%) were females. The overall median age was 37 years (interquartile range[IQR]: 23-62 years)...
October 2016: JPMA. the Journal of the Pakistan Medical Association
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