Complications of Obstetric Anaesthesia
Malik Goonewardene in Obstetric Emergencies, 2021
Anaesthetic complications contribute to maternal morbidity and mortality. The risks associated with anaesthesia develop due to the anatomical and physiological changes associated with pregnancy. Neuraxial anaesthesia in the form of subarachnoid, epidural or combined subarachnoid and epidural anaesthesia is more advisable over general anaesthesia as the lucid patient is able to maintain a patent airway and spontaneous respiration, thus reducing the risk of airway-related complications. Aspiration of particulate or acidic gastric contents causes obstruction of airways and pneumonitis. Aspiration pneumonitis in pregnancy is associated with a poor outcome. Difficulty in maintaining the airway in an obtunded pregnant woman is compounded by the anatomical and physiological changes of pregnancy. The incidence of difficult intubation and oxygenation is more common among pregnant women than in non-pregnant women. Anaesthetic drugs including inhalational agents, e.g. isoflurane, contribute to uterine hypotonia and can cause postpartum haemorrhage.
Neuroacupuncture for Central Nervous System Disorders
Len Wisneski in The Scientific Basis of Integrative Health, 2017
This chapter shows that the scope of neuroacupuncture in treating a variety of conditions and, will hopefully generate interest to stimulate research and expanded clinical practice. Neuroacupuncture has been found to have a positive effect on the sequelae of stroke, including hemiplegia, aphasia, and abnormal sensations in the limbs. Neuroacupuncture has demonstrated positive results with restless legs syndrome, and usually produces immediate beneficial responses in the initial treatment. Neuroacupuncture has been proven to have the most success in the treatment of Multiple Sclerosis and other central nervous system damage, as compared to other acupuncture modalities including on the ear, body, and hand. Neuroacupuncture has been found to have good results in children with cerebral palsy including paralysis, ataxia, hypotonia or hypertonia, apraxia, dysarthria, dysphasia, and mental retardation. Neuroacupuncture has been proven to be very effective, safe, and inexpensive for central nervous system disorders.
Hypotonia and weakness
James Bale, Joshua Bonkowsky, Francis Filloux, Gary Hedlund, Paul Larsen, Denise Morita in Pediatric Neurology, 2017
Hypotonia and muscle weakness, relatively common clinical presentations in infants or young children, result from many different conditions, including disorders of muscle, neuromuscular junction, peripheral nerve and the central nervous system (CNS). Specific diagnoses are influenced by age, sex, the rate of progression and the presence of other signs and symptoms; characteristic features may enable the clinician to recognize specific disease patterns. This chapter describes important causes of hypotonia and weakness in infants, children and adolescents, focusing on neonatal hypotonia, spinal muscular atrophy, DMD, congenital myopathies, dermatomyositis and MG.
Hypotonia, Jaundice, and Chiari Malformations: Relationships to Executive Functions
Published in Applied Neuropsychology: Child, 2013
This article postulates that movement and action control are the underpinning of executive functioning. We selectively examine brain regions that have traditionally been almost exclusively understood as critical to the control and expression of movement—namely, the basal ganglia and the cerebellum. We first describe the relationship between movement and cognition. This is followed by a review of common developmental disorders that are known to exhibit abnormal executive functions and movement anomalies. Against that background, we examine hypotonia, neonatal jaundice, and Chiari I malformation, and we demonstrate why these are “at-risk” factors for neurodevelopmental disorders that can feature both motor control and executive function abnormalities. Our goal is to prepare the clinical neuropsychologist for gathering information about these features of a child's birth and developmental histories, while using this as a framework for interpreting test results and applying test data in a useful, practical way to guide descriptive diagnosis and treatment.
Hypotonia and delayed motor development as an early presentation of Lowe syndrome: case report and literature review
Published in Acta Clinica Belgica, 2019
Sara David, Kathleen De Waele, Bram De Wilde, Franny Faes, Olivier Vanakker, Sophie Walraedt, Agnieszka Prytuła
We describe a boy who presented with neonatal hypotonia, followed by delayed motor development and growth impairment. Further evaluation revealed rickets caused by proximal renal tubular dysfunction. At age 3, the boy exhibited dysmorphic features and bilateral cataract. Genetic analysis of the OCRL gene showed a novel variant in exon 13: c.1250T>A, p.Val417Asp; in silico and segregation analysis confirmed the variant to be pathogenic, compatible with the diagnosis of the oculocerebrorenal syndrome of Lowe. Lowe syndrome is a rare multisystemic disorder; the diagnostic triad requires involvement of the eye, central nervous system and the proximal renal tubule. Typical clinical features are congenital cataract, glaucoma, hypotonia, mental and behavioral problems, benign skin lesions, platelet dysfunction and dental abnormalities. Phenotypic features early in life may be nonspecific, which is illustrated by this case with a late manifestation of cataract. Because an early diagnosis can lead to better counseling and treatment, we suggest urinary testing for proteinuria as a part of the evaluation of children with unexplained hypotonia.
Neurological impairments in hypoxic neonates and lactate levels
Published in Neurological Research, 2018
Miljana Z. Jovandaric, Svetlana J. Milenkovic
Introduction: Metabolic acidosis with increasing lactate concentration develops due to the lack of oxygen in the tissues. Objectives: The effect of lactic acidosis on neurological development in the first year of life. Materials and Methods: Our study included 50 newborns with perinatal hypoxia requiring oxygen therapy and 50 healthy newborns. pH, pCO2, pO2, base excess (BE) and lactates from arterialized capillary blood were determined in both groups of newborns, in the first and second hours after birth, and neurological development in the first year of life was estimated. Results: pH, pCO2, pO2, BE and lactates differed significantly between the groups in the first and second hours after birth p
Related Knowledge Centers
- Diagnosis
- Motor Neuron
- Muscle Tone
- Brain
- Neuromuscular Manifestations
- Physical Therapy
- Occupational Therapy