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Query: UMLS:C0038379 (strabismus)
 9,317 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A consecutive series of 140 children was observed after strabismus surgery. All the postoperative problems are attributable to general anaesthesia, vomiting and drowsiness being the principal ones. Respiratory difficulties were unusual. There is no reason to keep a healthy child in hospital for longer than one night, and day case strabismus surgery appears to be safe if (1) an experienced doctor gives the anaesthetic, (2) there is adequate supervision for 3 to 4 hours after surgery, (3) the appropriate district nurse is forewarned that a child is returning home after general anaesthesia, and (4) facilities are available to retain a child in hospital if a problem arises before discharge. Signs of emotional trauma may be less in children treated as day cases than in those hospitalized for one or more nights.
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PMID:Day case surgery for strabismus in children. 27 97

This review focuses on the features of pseudotumor cerebri in the pediatric age group. There is no sex predilection in children, and obesity does not appear to be an important factor. Infants and young children may present with irritability, apathy, or somnolence, rather than headache. Dizziness and ataxia may also occur. Papilledema is infrequently noted in pediatric patients if the fontanelles are open or the sutures are split. Pre-adolescents appear more likely than adults or adolescents to have manifestations of their pseudotumor cerebri other than headache and papilledema, including lateral rectus pareses, vertical strabismus, facial paresis, back and neck pain. Among the etiologies that are particularly pertinent to children are tetracycline therapy, malnutrition or renutrition, and the correction of hypothyroidism. Children with pseudotumor cerebri are at risk for visual loss and their visual function must be closely monitored. Surgical intervention is imperative when vision is threatened.
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PMID:Pediatric pseudotumor cerebri (idiopathic intracranial hypertension). 147 50

Vomiting in the postoperative period is common in children after strabismus surgery. One hundred ten pediatric patients, ages 8 months to 14 yr, admitted for outpatient strabismus surgery were enrolled in a randomized, double-blinded study to compare droperidol and metoclopramide to placebo for the prevention of postoperative emesis. Each child was prospectively assigned at random to one of four treatment groups: metoclopramide 0.15 mg/kg, metoclopramide 0.25 mg/kg, droperidol 0.075 mg/kg, or saline control. Drugs were administered intravenously immediately after induction of inhalation anesthesia. No neuromuscular blocking agents were used. Tracheal extubation was performed while patients were still deeply anesthetized. Acetaminophen and meperidine were given in standard doses for postoperative pain to all children. The incidence of vomiting was less in both the droperidol (33%) and metoclopramide 0.25 mg/kg (29%) groups when compared to controls (88%) (P less than 0.01). Patients receiving metoclopramide 0.15 mg/kg had a 68% incidence of vomiting (P not significant). The mean frequency of emesis was reduced in all treatment groups compared with control (P less than 0.05). Patients receiving droperidol and metoclopramide 0.25 mg/kg also had decreased postoperative stays (metoclopramide 201 min; droperidol 213 min) versus control (258 min, P less than 0.05). No child exhibited extrapyramidal symptoms, excessive drowsiness, or agitation. We conclude that metoclopramide in a dose of 0.25 mg/kg, administered prior to the start of surgery, is at least as effective as droperidol in preventing postoperative emesis and can reduce the time to patient discharge compared to control.
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PMID:A double-blinded comparison of metoclopramide and droperidol for prevention of emesis following strabismus surgery. 153 45

Three placebo-controlled double-blind and crossover trials were carried out to analyze the effects of oral yohimbine (YOH) 0.8 mg/kg on mood and performance in 16 healthy students. Subjective assessments (visual analogue scales, side-effects on questionnaire) and objective measurements (digit symbols, flicker fusion, tapping, heterophoria) were done at baseline, and post treatment. YOH shifted the healthy subjects' mood towards feeling panicked, elevated systolic blood pressure and plasma prolactin concentrations, reduced digit symbol substitution, and induced drowsiness and passiveness. Caffeine (CAF) 10 mg/kg raised plasma cortisol and rendered the subjects slightly panicked. Muzziness, clumsiness, tremor, chills and nausea were common after both YOH and CAF. Diazepam (DZ) 0.3 mg/kg given at 60 min antagonized some effects of CAF but failed to antagonize YOH. Clonidine (CLO) 100 micrograms counteracted YOH effects on blood pressure but less the subjective and hormonal effects. CLO 200 micrograms partly antagonized the pressor, sedative but not the hormonal responses of YOH. DZ counteracted YOH effects on plasma cortisol on panic but not on other subjective measures or plasma prolactin. Since CLO did not abolish YOH-induced prolactin increase, it is suggested that these effects of YOH are mediated not only via adrenergic alpha 2-receptors; other mechanisms made important contributions.
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PMID:Anxiogenic effect of yohimbine in healthy subjects: comparison with caffeine and antagonism by clonidine and diazepam. 315 10

Eleven patients, aged 4 to 18 years, who were admitted to the hospital with the diagnosis of traumatic hyphema were placed on 24-hour cardiac (Holter) monitors. Ten of the 11 patients had episodes of bradycardia and bradyarrhythmias. Blood pressures monitored during the same period showed that the bradycardia was not hemodynamically significant. Cardiac monitoring was repeated on six patients 3 months later, and nocturnal cardiac rhythms were compared; the minimum heart rates immediately following the eye injury were significantly lower (p = .03) than those measured 3 months later. While these data do not establish a relationship between bradyarrhythmias and the frequently-observed occurrence of somnolence, it does appear that episodes of bradyarrhythmias represent a common physiologic response to traumatic hyphema, and they can be expected to resolve spontaneously.
J Pediatr Ophthalmol Strabismus
PMID:Bradycardia with traumatic hyphema in children. 369 87

Low doses (0.05 mg/kg) of intravenously administered droperidol were given intraoperatively to randomly assigned pediatric strabismus patients in a controlled double-masked paradigm. No difference between control and treatment groups in the severity of vomiting was noted in the postanesthesia recovery room, but such a difference was probably present in the hospital rooms during the interval between room arrival and the meeting of hospital discharge criteria. Administration of the drug did not appear to produce somnolence sufficient to delay postoperative recovery.
J Pediatr Ophthalmol Strabismus
PMID:Antiemetic effectiveness of intraoperatively administered droperidol in pediatric strabismus outpatient surgery--preliminary report of a controlled study. 701

We employed polygraphic recordings and behavioral measures to study the effects of chronic morphine use upon the isolated forebrain and the decerebrate animal in cats with a midbrain transection. Cats received morphine for 12 days, and 24 h recording sessions were conducted on days 1 and 11. For the decerebrate cat, the percent time of rapid eye movement (REM) sleep was reduced during the 24 h period on both days 1 and 11. However, the values on day 11 were consistently higher than the values on day 1. Other tolerance indicators were decreases in the number of early behavioral signs and in the onset delay for REM sleep, together with an increase in onset time for motor activation. After naloxone (day 12) all cats displayed "wet shakes," tachypnea and eye squinting, as well as either pyloerection, elevated tail, salivation, licking, micturition, and yawning. In the isolated forebrain, the percent time for waking increased through the first 18 h post-morphine on both days 1 and 11. Conversely, the duration of non-REM (NREM) sleep and of drowsiness decreased. But importantly, the duration of sleep-waking states did not vary between days 11 and 1, indicating absence of tolerance. Additionally, after naloxone, the isolated forebrain entered NREM sleep, contrasting with opposite findings in intact cats. Therefore, while we could not demonstrate chronic use effects in the isolated forebrain, the decerebrate cat still displayed typical tolerance/withdrawal manifestations. This suggests that the effects of chronic opiate use are deeply seated in the brain stem, which might help understanding the ingrained nature of physical dependence.
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PMID:The brain stem but not forebrain independently supports morphine tolerance and withdrawal effects in cats. 1468 54

Acute disseminated encephalomyelitis (ADEM) is a rare acute inflammatory demyelinating disorder of central nervous system characterized by multifocal white matter involvement. Children and young adults are more commonly affected. The onset of ADEM usually follows a viral infection or immunization after a mean period of 7-14 days. The pathogenesis is not clear but several evidences support the autommune aetiology. ADEM is characterized by multifocal neurological signs and occasionally it rapidly progresses to coma. Magnetic resonance imaging (MRI) is useful to confirm the diagnosis. Treatment is based on intravenous high dose methylprednisolone, which usually leads a rapid improvement. Recently the use of i.v. immunoglobulins has also been suggested. We report a case of a 2-year-old girl with sudden onset of neurological symptoms (irritability, drowsiness, hemiparesis, ataxia, strabismus) after an upper respiratory tract infection. MRI showed the presence of multiple high signal areas in the brain and in the spinal cord. High doses of methylprednisolone (10 mg/Kg) i.v. determined a rapid and persistent improvement of neurological signs and symptoms.
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PMID:[Acute disseminated encephalomyelitis (ADEM): report of a clinical case]. 1692 56

We describe a 2-year-old baby affected by Smith-Magenis syndrome (SMS), due to 17p11.2 deletion, who presented repeated episodes of hemoglobin desaturation during REM sleep. The boy, aged 14 months, presented a phenotype characterized by psychomotor delay, right posterior plagiocephaly, telecanthus, strabismus, upslanting palpebral fissures, broad hypoplastic nasal bridge, short philtrum, deep ring shaped skin creases around the limbs, proximal syndactyly, bilateral hypoacusia. Polysomnographic (PSG) recording showed episodes of REM-related hypoventilation (hemoglobin desaturations without apneas or hypopneas). Sleep disorders are present in almost all the cases of SMS, but very few reports describe the sleep-related respiratory patterns. The finding of REM hypoventilation in SMS does not allow an unequivocal interpretation. It could reflect a subclinical restrictive respiratory impairment or, alternatively, an impairment of central respiratory control during REM sleep. In SMS children, respiratory abnormalities during sleep, and in particular during REM sleep, may cause sleep disruption, reduction of time spent in REM sleep, and daytime sleepiness. We therefore suggest that some sleep abnormalities described in SMS could be consequent to Sleep Disordered Breathing, and in particular to REM hypoventilation. Sleep studies in SMS should include the recording of respiratory parameters.
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PMID:Hypoventilation in REM sleep in a case of 17p11.2 deletion (Smith-Magenis syndrome). 2018 11

Moebius syndrome (MS) is a congenital syndrome characterized by unilateral or bilateral aplasia of the VI and VII cranial nerves, with consequent convergent strabismus and bilateral peripheral facial paralysis. This syndrome might be associated with diurnal excessive sleepiness and muscular hypotony, mimetizing in this manner, narcolepsy. The diagnostic criteria for narcolepsy depend on the presence of REM sleep during the day. As with patients with MS we do not have ocular movements due to the VI nerve paralysis, the absence of horizontal ocular movements might make it difficult to confirm narcolepsy in these patients. The common clinical characteristics of these patients are due to a possible impairment of the same structures that are affected in the central nervous system. However, the mechanism by which it occurs remains to be fully understood. Further electrophysiological researches are necessary to better clarify the association of these two diseases. The objective of this dissertation is to describe and discuss a case of Moebius syndrome with diurnal excessive sleepiness as a differential diagnosis for narcolepsy.
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PMID:Moebius syndrome and narcolepsy: A case dissertation. 2648 99


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