Encephalopathy hypoxic

Hypoxic-ischemic encephalopathy in asphyxiated full-term infants... 

Succinylcholine-induced rhabdomyolysis Hypoxic encephalopathy Intrathecal administration of constant agents Defective temperature-monitoring devices Stimulation during light anesthesia... 

Nystagmoid jerking of one eye may occur in mid-to lower pontine lesions (Plum and Posner 1980). Ocular bobbing consists of sudden bilateral downward movement of both eyes followed by slow return to mid position. Pontine and cerebellar lesions as well as metabolic and encephalitic disorders may cause ocular bobbing. Inverse ocular bobbing ( ocular dipping ) may occur in hypoxic encephalopathy (Stark et al. 1984). 

Christophe C, Clercx A, Blum D, Hasaerts D, Segebarth C, Perlmutter N (1994) Early MR detection of cortical and subcortical hypoxic-ischemic encephalopathy in full-term-infants. Pediatr Radiol 24 581-584... 

Two premature neonates, who already had epileptic manifestations related to severe hypoxic ischemic encephalopathy, developed seizures (one tonic and the other tonic-clonic) within a few seconds of receiving intravenous midazolam (0.15 pg/kg) for sedation (25). In one, the seizure recurred after rechallenge on the same day. Benzodiazepines occasionally cause tonic seizures, especially after intravenous administration to children with Lennox-Gastaut syndrome. This seems to be the first report related to midazolam in newborns. 

Armstrong DL, Battin MR. Pervasive seizures caused by hypoxic-ischemic encephalopathy treatment with intravenous paraldehyde. J Child Neurol 2001 16(12) 915-17. 

Mannitol, the most commonly employed osmotic diuretic, is a large polysaccharide molecule. It is often selected for use in the prophylaxis or treatment of oliguric ARF. It is not absorbed from the gastrointestinal tract and, therefore, is only administered i.v. with its elimination dependent on the GFR (within 30 to 60 min with normal renal function). Mannitol is distributed within the plasma and extracellular fluid spaces and produces an increase in the serum osmolality and expansion of the circulating volume. It is not generally used for the treatment of edema because any mannitol retained in the extracellular fluid can promote further edema formation. Furthermore, acute plasma volume expansion may challenge individuals with poor cardiac contractility and can precipitate pulmonary edema. Mannitol is commonly administered for the treatment of cerebral edema consequent to head trauma or to hypoxic-ischemic encephalopathy in neonatal foals. Because mannitol promotes water excretion, hypernatremia is a potential complication in patients that do not have free access to water (Martinez-Maldonado Cordova 1990, Wilcox 1991). 

New research in human patients suggests a role for moderately hypertonic saline solutions (1.6-3%) in children with head injuries (Khanna et al 2000, Peterson et al 2000, Simma et al 1998). Whether this might also be useful in head injury or hypoxic ischemic encephalopathy in neonatal foals remains to be evaluated. 

DeReuck J, Decoo D, Vienne J, et al Significance of white matter lucencies in post-hypoxic-ischemic encephalopathy comparison of clinical status and of computed and positron emission tomographic findings. Eur Neurol 32 334-339,1992... 

Shi Y, Pan F, Li H, et al Role of carbon monoxide and nitric oxide in newborn infants with postasphyxial hypoxic-ischemic encephalopathy. Pediatrics 106 1447-1451,2000... 

Filippi L, Poggi C, la Marca G, Furlanetto S, Fiorini P, Cavallaro G, Plantulli A, Donzelli G, Guerrini R. Oral topiramate in neonates with hypoxic ischemic encephalopathy treated with hypothermia a safety study. J Pediatr 2010 157(3) 361-6. 

McPherson RJ, Juul SE. Erythropoietin (Epo) for infants with hypoxic-ischemic encephalopathy (HIE). Curr Opin Pediatr 2010 22(2) 139 5. 

Rutherford M, Pennock J, Schwieso J, Cowan F, Dubowitz L. Hypoxic-ischaemic encephalopathy early and late magnetic resonance imaging findings in relation to outcome. Arch Dis Child Fetal Neonatal Ed 1996 75(3) F145—F151. 

Huang CC. Perinatal hypoxic/ischemic encephalopathy clinical challenge and experimental imphcations. Zhonghua Min Guo Xiao Er Ke Yi Xue Hui Za Zhi 1998 39 157-165. 

Perlman M, Shah P (2008) Time to adopt cooling for neonatal hypoxic-ischemic encephalopathy Response to a previous commentary. Pediatr 121 616-618... 

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