Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report two patients presenting for thalamotomy in whom tremor was abolished for 8 h after propofol anaesthesia. Propofol has two contrasting actions. It may have an anti-Parkinsonion effect, abolishing abnormal limb movements. On other occasions, propofol is known to induce spontaneous abnormal limb movements, as well as epileptiform activity. Propofol is probably best avoided for stereotactic procedures. It is difficult to reconcile these two opposing actions.
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PMID:Propofol--contrasting effects in movement disorders. 794 34

We studied the effects of propofol on electrophysiologic monitoring for functional neurosurgery. In six patients with intractable epilepsy, electrocorticograms (ECoGs) were monitored for epilepsy surgery, and in two of them, somatosensory evoked potentials (SEPs) were monitored because of the focus adjacent to the central sulcus. In four patients with hemifacial spasm, brain stem auditory evoked potentials (BAEPs) and abnormal muscle responses (AMRs) were monitored during microvascular decompression (MVD). In two patients with Parkinson's disease and in one patient with post-traumatic tremor, neural noise levels were recorded from microelectrodes during posteroventral pallidotomy and Vim thalamotomy. In each case of epilepsy surgery, during intravenous anesthesia with propofol, spike activity was recordable enough to identify the resective area and the residual spikes. SEP phase reversal was obtained in two patients and an exact determination of the central sulcus was possible. BAEPs and AMRs were obtained in all MVDs. To record neural noise levels, the infusion of propofol was decreased in two cases of posteroventral pallidotomy, and it was stopped in one case of Vim thalamotomy. In these patients, neural noise levels were recorded and were useful for identifying the target. Propofol is a potentially useful anesthetic agent for electrophysiologic monitoring during functional neurosurgery.
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PMID:[Intraoperative monitoring for functional neurosurgery during intravenous anesthesia with propofol]. 905 30

We have compared the physical properties of two commercial emulsion formulations of the intravenous anaesthetic propofol, (Diprivan, AstraZeneca, and Propofol Intravenous Emulsion, Gensia Sicor Pharmaceuticals) which appear to differ primarily in the additive content and formulation pH. Diprivan contains disodium edetate and has a pH of 7-8.5, while the Gensia product contains sodium metabisulphite and is formulated to a pH of 4.5-6.4. The average zeta potential of Diprivan at pH 8 was -50 mV while that of the Gensia product at pH 4-5 was -40 mV. This information suggests that the physical stability of Propofol Intravenous Emulsion should be lower than that of Diprivan. Three random batches of both products were subjected to a range of stability tests, including shaking, thermal cycling, and freeze-thaw cycling, and the emulsion droplet size distribution was then assessed by dynamic light scattering, light diffraction, and electrical and optical zone sensing. Both emulsions initially showed narrow submicrometre particle size distributions. An increased level of droplets larger than 5 microm could be detected in Propofol Intravenous Emulsion after as little as 4 h shaking (300 strokes/min at room temperature) and visible free oil could be detected after 8-12 h shaking. In contrast, Diprivan showed no increase in the large droplet count after shaking for times up to 16 h. A similar difference in the emulsions was found after one freeze-thaw cycle, with Propofol Intravenous Emulsion exhibiting extensive coalescence, while that of Diprivan was at the limits of detection. We conclude that these two products have different physical stability characteristics, and that this may in part be due to the reduced zeta potential in Propofol Intravenous Emulsion compared to that of Diprivan.
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PMID:Physical properties and stability of two emulsion formulations of propofol. 1125 Jan 6

The characteristics of recovery from total intravenous anesthesia (TIVA) with propofol and inhalation anesthesia with isoflurane was clinically compared in 149 client-owned dogs that anesthetized for surgical or diagnostic procedures. In all dogs, anesthesia was induced with an intravenous injection of propofol following premedication with acepromazine or diazepam. As a result, 58 dogs anesthetized with propofol-TIVA showed slower but smoother recovery than 91 dogs anesthetized with isoflurane anesthesia. The dogs stood at 34.5 +/- 19.3 and 27.7 +/- 17.2 min after propofol-TIVA and isoflurane anesthesia, respectively. Adverse effects, including hypersalivation, neurologic excitement (paddling, muscle tremor/twitching, opisthotonos) and vomiting/retching, were observed in similar infrequent incidences during the recovery from both anesthetic protocols. Propofol-TIVA is suggested to be an alternative anesthetic protocol for canine practice.
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PMID:Clinical comparison of recovery from total intravenous anesthesia with propofol and inhalation anesthesia with isoflurane in dogs. 1805 35

A 31-year-old woman with a left frontal and parietal brain tumor underwent awake craniotomy. Propofol/remifentanil general anesthesia was induced. Following craniotomy, anesthetic administrations ceased. The level of consciousness was sufficient and she was not agitated. However, the patient complained of nausea 70 minutes into the awake phase. Considering the adverse effects of antiemetics and the upcoming surgical strategy, we did not give any medications. Nausea disappeared spontaneously while the operation was suspended. When surgical intervention extended to the left caudate nucleus, involuntary movement, classified as a tremor, with 5-6 Hz frequency, abruptly occurred on her left forearm. The patient showed emotional distress. Tremor appeared on her right forearm and subsequently spread to her lower extremities. Intravenous midazolam and fentanyl could not reduce her psychological stress. Since the tremor disturbed microscopic observation, general anesthesia was induced. Consequently, the tremor disappeared and did not recur. Based on the anatomical ground and the medication status, her involuntary movement was diagnosed as psychogenic tremor. Various factors can induce involuntary movements. In fact, intraoperative management of nausea and vomiting takes priority during awake craniotomy, but we should be reminded that some antiemetics potentially induce involuntary movement that could be caused by surgery around basal ganglia.
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PMID:[A Case of Psychogenic Tremor during Awake Craniotomy]. 2700 92