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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A total of 600 handicapped patients had dental rehabilitation under general anesthesia during an eight-year period. Handicaps included mental retardation, cerebral palsy, Down syndrome, seizure disorders, autism, cystic fibrosis, osteogenesis imperfecta, and muscular dystrophy. No significant complications developed in the majority of patients. This is attributed to thorough preoperative evaluation, appropriate anesthetic management, and vigilant postoperative observation.
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PMID:Complications related to the administration of general anesthesia in 600 developmentally disabled dental patients. 15 47

The case is reported of a four-year-old boy with progressive muscular dystrophy who underwent anal fistulectomy under neuroleptanaesthesia with Thalamonal. Recovery was uneventful. Anaesthetic problems associated with the disease include sudden death due to myocardial involvement and high postoperative mortality due to pulmonary infection. Mental retardation and ECG abnormalities may be present and acute postoperative gastric dilatation has been reported. Narcotics or minor tranquilizers and hyoscine are recommended for premedication. Light anaesthesia should be maintained throughout surgery and minimal doses of non-depolarizing muscle relaxants may be used if necessary. Suxamethonium chloride should be avoided because muscle damage and cardiac arrest might occur.
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PMID:General anaesthesia for a patient with progressive muscular dystrophy. 126 19

We report on oral ketamine for the preinduction of 3 patients who aggressively refused the commonly used induction of anaesthesia, due to young age or mental retardation. One child and two mentally retarded patients aged 30 and 31 years who were to undergo dental surgery aggressively refused the induction of anaesthesia, either by inhalation or rectal, intramuscular, or intravenous application of drugs. One of them previously injured the medical personnel and destroyed the interior equipment of a gynaecologist, who tried to perform an examination. After having received 6 to 8 mg/kg body weight ketamine in 10 ml water, which they accepted well, probably because of the long lasting fluid restriction (about 12 hours), they tolerated the induction of anaesthesia by inhalation (2 patients) or intravenously (1 child). Two patients remained awake, but calm, one fell deeply asleep. After several hours of surgery in inhalation anaesthesia they could be extubated within several minutes and discharged the same day. We conclude that 5 to 10 mg/kg oral ketamine in water which has a bioavailability of approximately 20% is a useful agent for the preinduction of patients who aggressively refuse medical treatment. Because deep sleep states cannot be excluded, we recommend a careful supervision after the application of ketamine. Nevertheless, we could discharge our patients on the same day even after long lasting surgical procedures; this makes this method useful in day case surgery.
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PMID:[Oral ketamine as preferred preanesthetic medication of uncooperative patients]. 145 Mar 15

Mentally retarded individuals are, since 1984 a priority group for the Norwegian public dental health service. This group of patients may have many problems which affect oral health. Difficulties with feeding are common, as are various oral motor problems like rumination, bruxism, mouth breathing and drooling. The impaired oral function may cause retention of food, reduced self-cleaning from lips and tongue and long-term use of puree food. Obstipation is a common problem which is often treated with prunes, raisins or sweetened laxatives. In behaviour modification programs sweets are often used as rewards. Tooth cleaning may cause problems for many parents and caretakers due to lack of cooperation or anatomical malformation of oral structures or teeth. Dental treatment may also be difficult to perform. Recent research in Nordic countries supports earlier reports that mentally retarded individuals have a high incidence of plaque, periodontal disease and malocclusion. Caries does not seem to be a problem. Nevertheless, older individuals with mental retardation have more untreated caries and missing teeth than average. Early intervention with oral motor training and frequent regular preventive treatment (4 x per year) will reduce caries, periodontal disease, early tooth loss and the need for treatment under general anesthesia in the future.
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PMID:[The mentally retarded and the dental health services. Treatment needs and preventive strategies]. 183 93

Routine gynecologic care for persons with mental retardation may be difficult to provide, especially to those women who do not allow a pelvic examination to be performed. Of 275 women referred to a multidisciplinary clinic addressing the reproductive health concerns of mentally retarded women, 61 patients (22%) did not allow a gynecologic examination to be performed. The administration of ketamine alone, midazolam alone, or a combination of midazolam and ketamine allowed for the successful performance of a gynecologic examination in 81% of previously uncooperative women. No adverse effects of the medications were noted. We conclude that sedation of difficult-to-examine, mentally handicapped women can be safely performed in the outpatient setting, thus avoiding the need for general anesthesia and its inherent risks.
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PMID:Outpatient sedation: an essential addition to gynecologic care for persons with mental retardation. 200 49

Sotos' syndrome (synonym: cerebral gigantism) is the association of mental retardation, macrocephaly and prenatal onset of accelerated growth. The rapid skeletal growth may account for a 4% incidence of scoliosis. General anaesthesia using halothane or enflurane in nitrous oxide and oxygen, with opioid supplementation and labetalol to induce moderate hypotension, appeared to be a satisfactory technique for corrective spinal surgery. The potential problems are discussed, with mental retardation and sometimes aggressive behaviour contraindicating a "wake-up" test. Extradural somatosensory evoked potential monitoring is a satisfactory alternative. Hook failures seem more likely than in patients undergoing surgery for adolescent idiopathic scoliosis.
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PMID:Posterior spinal fusion in Sotos' syndrome. 206 91

Complete dental treatment of 180 children has been undertaken under general anaesthesia. Indications for this were mental retardation and dental fear. Because of the simple technique and advantageous pharmacological properties, ketamine, and later its Hungarian analogue, Calypsol, were used.
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PMID:General anaesthesia of out-patients in pedodontics. 215 17

Cornelia de Lange syndrome presents various problems for anesthetic management, which include anatomical anomalies of face and extremities, cardiopulmonary and endocrine disorders, renal dysfunction, epileptic EEG waves, and mental retardation. The choice of anesthetic procedure must be carefully considered in view of these abnormalities. We administered halothane anesthesia to an 11-year-old child with this syndrome who needed dental treatment. Anesthesia and postoperative course were uneventful, with the exception of a transient bronchospasm-like attack during anesthesia.
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PMID:Anesthetic management of a patient with Cornelia De Lange syndrome. 295 21

Calcium hopantenate (HOPA-Ca), which is obtained by substituting the beta-alanine of pantothenic acid for gamma-amino butyric acid (GABA), is a therapeutic drug for mental retardation and cerebrovascular dementia. HOPA-Ca is known to produce convulsive seizures in some patients although it is also true that this improves EEG abnormalities and suppresses epileptic seizures. Thus, clinical observations suggest that HOPA-Ca exerts a paradoxical influence on epilepsy. In order to gain further insight into the influence of HOPA-Ca on epilepsy, we examined its effects on the generalized seizure-triggering threshold (GST) of kindled amygdaloid (AM) seizure and on the rate of AM kindling in rats. Male Wistar rats weighing 200-250 g were used. Under pentobarbital anesthesia, a bipolar electrode, made of twisted stainless steel wire 0.2 mm in diameter, was stereotaxically implanted into the left AM. Daily electrical stimulation was given at the intensity of afterdischarge threshold (ADT). Electrical stimulation was continued until at least five consecutive generalized convulsions were evoked. Subsequently, the stimulus intensity was daily lowered by 20-microA steps and the last stimulus intensity for evoking generalized convulsion was designated as the GST. Experiment 1. Influence of HOPA-Ca on the GST; HOPA-Ca was dissolved in saline as a vehicle. Injections of 50, 100, 250, 500 mg/kg HOPA-Ca were given intraperitoneally 60 min before the stimulation at the GST. The GST never changed with vehicle injection. The GST increase was never observed with any amount of HOPA-Ca. However, the GST dropped flowing HOPA-Ca infection independent of its amount. The GST reduction was always 20-microA.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Facilitatory effect of calcium hopantenate on amygdaloid kindling in rats]. 322 34

The case of a 12 years old boy with a congenital anaesthesia covering all cutaneous and visceral districts is reported. There were no other neurological abnormalities apart a light mental retardation and loss of axon reflex after intradermal injection of hystamine. Notwithstanding this last finding a diagnosis of congenital indifference to pain was made. The differential diagnosis between indifference and insensitivity to pain is discussed.
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PMID:[Congenital analgesia]. 616 89


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