Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0037315 (sleep apnea)
 8,000 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A 48-year-old female with multiple sclerosis (MS) accompanied by intractable hiccups of over one month' duration and the sleep apnea syndrome was reported. This MS patient had been well controlled until September 16, 1991 when she experienced nausea, vomiting and hiccups. The patient was admitted to Kawasaki Medical School Hospital on October 9, 1991. A physical examination revealed intractable hiccups. T1-weighted MRI showed a low and T2-weighted image disclosed a high signal intensity area in the tegmentum of the medulla oblongata. The intractable hiccups and vomiting improved with intravenous high dose methylprednisolone injection therapy. The following day, she complained of insomnia and her family observed severe snoring and apnea during the night. These symptoms and the results of a breathing monitor were compatible with the sleep apnea syndrome. These symptoms disappeared following the administration of amitriptyline. There have been few reports of the combination of intractable hiccups and the sleep apnea syndrome in MS. The MRI findings suggest that the causative lesion of these symptoms is in the tegmentum of the medulla oblongata.
 ...
PMID:[A case of multiple sclerosis with intractable hiccups and sleep apnea syndrome]. 129 Nov 66

Pharyngotomy appears to be insufficient for the treatment of severe sleep apnea. For patients who refuse or abandon mechanical ventilatory assistance, surgery can be used to widen the retrobasilingual space adapting it to the cephalometric profile defined by cineradiography and MRI in combination with velopharyngeal plasty. For patients with no maxillomandibular or lingual malformation, the pharyngotomy can be combined with an anterior transposition of the genial insertions of the tongue without rotation. A method different from that described by Riley and Powel is proposed. The details of the surgical procedure are exposed. The operation is indicated in snorers with sleep apnoea with an Apnea Index Superior to 30 who refuse nocturnal ventilatory assistance and who do not have a hypertrophied tongue (Surface less than 30 cm2) or maxillomandibular retroposition.
 ...
PMID:[A new technique of gene transposition in the surgical treatment of sleep apnea syndrome]. 757 44

All-night polysomnographic studies were performed on ten patients (all female) with rheumatoid arthritis complicated with temporomandibular joint destruction and cervical lesions. The mean age of these subjects was 67.5 yrs, ranging from 48-81 yr. They all had some morphologic abnormalities of cervical spines and/or temporomandibular joints. Sleep study revealed that all of them had sleep apnea; five of them were of obstructive type (obstructive group) while the remaining showed central type of sleep apnea (central group) predominantly. There were no statistically significant differences of the levels of apnea index, mean-nadir SO2 and the lowest SO2 between the obstructive group and the central group. No detectable differences of cephalographic measurements and MRI findings existed between the two groups either. In one patient, nasal-CPAP converted central apnea to normal breathing dramatically. Our observations indicate that the cause of central apnea in RA patients with temporomandibular lesions is collapse of upper airway, inducing inhibitory inputs from the mechanoreceptors in that region.
 ...
PMID:[Sleep apnea syndrome in rheumatoid arthritis (RA) patients complicated with cervical and temporomandibular lesions]. 773 87

Twenty-eight consecutive patients with multiple sclerosis (MS) were clinically evaluated to determine the presence of sleep-related disorders. There were 12 males and 16 females aged between 22 and 67 with disability ranging between 1.5 and 8.5 on Kurtzke extended disability status score (EDSS). Fifteen patients (54%) reported sleep-related problems. These included difficulties initiating sleep and/or frequent awakenings due to spasms or discomfort in the legs (8 patients), difficulty in initiating or maintaining sleep (3), habitual snoring (4) and nocturia (1). All-night oximetry was performed and the tracings analysed for the number of dips in oxygen saturation (SaO2) or more than 4%. Three patients showed significant sleep-related oxygen desaturation (> 5 dips of > 4% SaO2/h). Subsequent polysomnography performed in 2 of the 3 patients with significant oxygen desaturation confirmed the presence of sleep apnoea. MRI analysis of brain stem regions showed abnormalities in 20/22 cases. The 3 patients showing nocturnal oxygen desaturation had MRI brain stem lesions, but their locations were variable and their general appearance not different from that seen in the 17 without sleep apnoea. Sleep disturbance in MS is common but poorly recognised. It is usually due to leg spasms, pain, immobility, nocturia or medication. It is much less commonly associated with nocturnal respiratory insufficiency.
 ...
PMID:Sleep problems in multiple sclerosis. 785 52

A review of 16 pediatric patients examined and treated from 1987 to 1991 is presented. The purpose for this review was to examine the different initial clinical presentation in the younger age group versus the older child and to identify the factors impacting on the patients' surgical outcome, including the patients' age, clinical presentation and MRI findings. Patients' ages ranged from 4 to 14 years. Ten were under 6 years of age. Seven males and 9 females were included. The diagnosis was confirmed by MRI in all patients and all were followed by clinical and MRI evaluations for at least 1 year postoperatively. The patients were grouped into three subgroups: (a) group IA patients with a Chiari I malformation, (b) group IB patients with a Chiari I malformation and syrinx, and (c) group IC patients with a Chiari I malformation and hydrocephalus with or without an associated syringomyelic cavity. A uniform surgical approach was used and tailored to the degree of anomalies seen on MRI. Patients with a Chiari IA and IB were treated by a suboccipital craniectomy, upper cervical laminectomy, arachnoidal retraction and duraplasty. Only 1 patient in group B required a syringosubarachnoid shunt initially. Patients with a Chiari IC malformation were treated by a ventriculoperitoneal shunt initially. The clinical presentation of younger children (less than 6 years old) appeared similar to older children (over 6 years of age) except for sleep apnea, which was limited to the younger age group. Patients with pronounced motor and sensory deficits had the worst prognosis for recovery.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:An approach to symptomatic children (ages 4-14 years) with Chiari type I malformation. 794 7

A 51-year-old right-handed man with dilated cardiomyopathy, sleep apnea and atrial fibrillation suddenly suffered from transient color imperception, which completely recovered next morning. During the attack, both color naming and color pointing were severely disturbed, while he could correctly state the colors of named objects. There were no additional neuropsychological disturbances such as aphasia, alexia and prosopagnosia. Brain MRI revealed a new ischemic change, i.e. laminar cortical necrosis, in the right fusiform gyrus as a causative lesion as well as old asymptomatic infarcts in the left middle cerebral arterial territory. Cardioembolism was considered to be responsible for the development of brain ischemia. The transient achromatopsia is a rarely reported disease and this case appears to support 'ischemia' as its etiology.
 ...
PMID:[Transient achromatopsia caused by cardioembolic brain ischemia]. 882

Two children complaining of sleep apnea presented with brain stem gliomas. In the early stage of their illness, neurological disorders were too subtle to be recognized as significant by the physicians or to be noted by the parents. Case 1 experienced an episode of unsteady gait and weakness in the bilateral arms, at the age of 5. When it recurred after 7 years of remission, the predominant symptom was sleep apnea. Case 2 exhibited nasality of speech as the earliest sign of this illness very early in his life, presumably 5 years before the diagnosis of brain stem glioma. A slight sleep apnea which developed afterwards did not draw attention of the physicians because no neurological signs other than paralyses of the bilateral soft palates were present. MRIs of the both cases revealed diffuse, infiltrating lesions in the pons, the medulla oblongata and the upper cervical spinal cord. Both cases shared some features: (1) diagnostic delay of several years from the first symptom; (2) the main lesion in the medulla oblongata, where important structures for respiratory control are identified; (3) infiltrative growth patterns in the MRI of the tumor, which might account for the uncommon clinical courses.
 ...
PMID:Pediatric brain stem gliomas with the predominant symptom of sleep apnea. 888 7

15 patients, aged 1-14 years, with sleep disordered breathing underwent turbo fast low angle shot MRI during drug-induced sleep. The site of obstruction within the pharynx was identified. Data from MRI were compared with fibroscopic findings. The degree of hypertrophy of the palatine tonsils as determined by MRI was also compared with that determined by visual inspection while awake. MRI was completed in all cases, whereas fibroscopy was completed in only six of the 10 cases examined. MRI findings agreed with those of fibroscopy in all the patients who underwent both investigations. On MRI, the pharynx was obstructed in 12 of the 15 cases examined (80%); the palatine tonsils were involved in all of these while both the palatine tonsils and nasopharynx were obstructed in three of the 12 cases. One of the 12 patients was graded as Grade I of Mackenzie's scale. One of the cases graded as Grade II showed no obstruction. In conclusion, fast MRI proved useful in identifying the site of pharyngeal obstruction in young patients with sleep disordered breathing.
 ...
PMID:MRI of the pharynx in young patients with sleep disordered breathing. 895 15

Twelve patients with complaints of sleep apnea were examined with the all-night sleep test. They underwent uvulopalatopharyngoplasty (UPPP) and were studied with the all-night sleep test again 3 to 6 months after the operation. Nasal and oral respiratory resistance was measured in sitting and supine position before and after surgery using a microrhinograph. The physiological effect of UPPP was also compared with the results of an MRI anatomical study. Nasal and oral respiratory resistance was significantly decreased post-operatively (p <0.05). The decreased value of post-operative nasal respiratory resistance in a supine position was more marked than that of oral resistance, suggesting that UPPP eliminates the obstruction at the soft palate, especially in a supine position. Although our study was performed in awake patients enlargement of the airway in the middle pharyngeal region may improve the nasal and oral respiratory function during sleep.
 ...
PMID:Changes in nasal and oral respiratory resistance before and after uvulopalatopharyngoplasty. 908 93

According to the obstructive site, different types of obstructive type sleep disordered breathing are classified as the soft palate type, palatine tonsil type, soft palate and depressed lingual root type, depression of the lingual root type, and epiglottis type. In this study, we conducted dynamic MRI examinations of the oral and pharyngeal and lingual root sites in patients with obstructive sleep disordered breathing, and studied MRI's usefulness as a diagnostic tool in the examination of such obstructive sites. In this paper, we present mainly the adult cases of patients with obstructive sleep disordered breathing which appeared to be caused by an enlarged palatine tonsil.
 ...
PMID:Diagnosis by dynamic MRI in sleep disordered breathing. 908 96


1 2 3 4 5 6 Next >>