Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0013421 (dystonia)
 8,418 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Dexmedetomidine, which is a relatively selective alpha2-adrenoceptor agonist, is used for sedation and analgesia in intensive care unit patients, during awake craniotomies in pediatric and adult patients, and during magnetic resonance imaging, with minimal depression of respiratory function. The successful use of dexmedetomidine in a pediatric patient undergoing bilateral deep brain stimulator placement for the treatment of generalized dystonia, is presented.
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PMID:Dexmedetomidine for deep brain stimulator placement in a child with primary generalized dystonia: case report and literature review. 1946 17

We aimed to identify the incidence, duration and causes of delayed emergence from anesthesia in patients with dystonia undergoing surgery for deep brain stimulation (DBS) placement. A retrospective review of patients with dystonia who underwent DBS placement was conducted and the following characteristics were noted: age, gender, comorbid conditions, American Society of Anesthesiologists classification, anesthetic agents used, amount of initial dose, amount of infusion dose, duration of the infusion and the time needed for emergence. Twenty-four patients underwent 33 DBS procedures for dystonia. Propofol was administered to 21 patients, in 29 of the 33 procedures. Dexmedetomidine was administered to three patients, in four procedures. The average propofol loading dose was 0.7mg/kg, and the infusion rate was 80microg/kg per minute (min), for an average duration of 89min. The average time of emergence was 36min. Only 31% of patients emerged from propofol anesthesia during the expected time frame, 69% of patients had some degree of delayed emergence, and 24% had a significant delay in emergence. Delayed emergence was more common in younger patients due to the higher loading doses these patients received. This study shows a 69% incidence of delayed emergence in dystonia patients undergoing DBS surgery. It also suggests an association between delayed emergence and younger patients who receive higher loading doses. A possible cause of delayed emergence is excessive anesthetic potentiation of the low output pallidal state in dystonia which may depress the pallido-thalamo-cortical circuitry. Delayed emergence could also result from depression of the previously affected ventral pallidal inputs to the septo-hippocampal system that mediates general anesthesia and awareness. Complex neurotransmitter disturbances may also be involved.
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PMID:Delayed awakening in dystonia patients undergoing deep brain stimulation surgery. 2046 47

Meige's syndrome is rare form of orofacial dystonia. There is unfortunately no cure, but occasionally patients may improve with time. We present the successful management of a palladial deep brain stimulator (DBS) implantation for Meige's syndrome. Dexmedetomidine infusion was used for sedation. The procedure lasted for around 12 h and the patient was comfortable, responsive, and cooperative over the extended period of time. The surgeons were comfortable with electrophysiologic brain mapping and clinical testing. DBS were implanted, through a burr hole, into the globus pallidus neurophysiological testing under guidance. The pulse generator battery was subcutaneously implanted into the chest wall under general anesthesia. The implanted pulse generator battery was started 2 days later and the patient showed dramatic improvement in his symptoms.
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PMID:Anesthetic management of deep brain stimulator implantation in Meige's syndrome. 2234 57