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Query: UMLS:C0023380 (lethargy)
 5,697 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The role of spinal cord injury in the pathogenesis of abnormal motor signs (depressed tone and reflexes) following severe perinatal hypoxia-ischemia was prospectively evaluated by clinical, electrophysiological, and neuropathological examinations in 18 asphyxiated neonates. All infants had an abnormal mental status (lethargy or coma), and seizures were present in 12. Neuromuscular examinations revealed hypotonia or flaccidity and hyporeflexia or areflexia in all infants. Neuropathological examinations of the cerebrum and spinal cord were conducted in the 12 neonates who expired. Cerebral pathological findings included cortical neuronal necrosis in 10 of 12 and subcortical white matter injury in 5 of 12. All infants with coma or seizures displayed diffuse cortical injury, but no injury conformed to a parasagittal "watershed" distribution. Spinal cord gray matter displayed prominent ischemic necrosis in 5 patients who were typically flaccid and areflexic. Electromyographic examinations of all 6 survivors were abnormal, consistent with recent injury to the lower motor neuron above the level of the dorsal root ganglion. We conclude that ischemic injury to anterior horn cells within spinal cord gray matter is relatively common among hypotonic-hyporeflexic neonates following severe perinatal hypoxia-ischemia. Although the acute neurological syndrome of neonatal asphyxia is often overshadowed by prominent cerebral signs such as coma and seizures, the motor abnormalities may be partially attributed to concurrent spinal cord injury.
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PMID:Hypoxic-ischemic spinal cord injury following perinatal asphyxia. 291 67

Birth asphyxia is one of the common causes of mortality and morbidity in neonates and the incidence is 2-9 per 1,000 live borns. The present work is a retrospective hospital based observational study. Babies born at B.P. Koirala Institute of Health Sciences, Dharan, Nepal during the period from April 2002 to April 2003 with gestational age >or=37 weeks with Apgar score <or=6 at 5 minutes were included in the study. The aim was to study the clinical profile, the acid base parameters and the outcome of asphyxiated newborns. Babies with congenital defects, evidence of infection and maternal drug addiction were excluded from the study. All babies were resuscitated according to the guidelines of American Heart Association. Data on 50 birth asphyxia cases were tabulated and analysed. There were 10 (20%) cases of severe birth asphyxia (Apgar score: 1-3 ) and 40 (80%) cases of moderate birth asphyxia (Apgar score: 4-6). Staging of hypoxic ischaemic encephalopathy (HIE) was performed according to Sarnat's staging. Thirty percent of these cases presented with various stages of HIE and the incidence was higher in low Apgar score group. The common presentations of HIE cases had depressed neonatal reflexes, seizures, lethargy, and pupillary abnormalities. The common acid base disturbance was metabolic acidosis which was observed only in babies with HIE-3. Two neonates (4%) died during the hospital stay due to multiorgan failure and severe metabolic acidosis.
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PMID:Outcome of newborns with birth asphyxia. 1655 70