Cases reported "Infant, Newborn, Diseases"

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1/8. Utility of early single photon emission computed tomography (SPECT) in neonatal gelastic epilepsy associated with hypothalamic hamartoma.

    Gelastic epilepsy, or laughing seizures, is a rare seizure manifestation often associated with hypothalamic hamartoma. This seizure type is well described in older children and adults, but has only rarely been reported in neonates, oftentimes recognized in retrospect when the children are older. We report a child diagnosed at 3 months of age with a large hypothalamic mass after evaluation for spells occurring since birth. The spells were characterized by bursts of hyperpnea, followed by repeated "cooing" respirations, giggling, and smiling. These spells were recognized soon after birth in the delivery room, and occurred at 15-20 minute intervals. They did not interrupt feeding and occurred during sleep. On referral to our center, the patient was noted to be thriving, with normal medical and neurologic examinations except for his spells. The laboratory evaluation was normal, as were endocrine and ophthalmologic evaluations. neuroimaging was performed, with magnetic resonance imaging demonstrating a large 2.8-cm isodense, nonenhancing hypothalamic mass. Electroencephalogram was abnormal, demonstrating bi-frontal sharp and spike-wave discharges. Video-EEG did not demonstrate ictal discharges associated with the patient's spells. Single photon emission computed tomography (SPECT) demonstrated dramatic ictal uptake in the area of the tumor, with normalization during the interictal phase. Partial excision of hamartomatous tissue has minimally improved the spells. In conclusion, this patient manifested an unusual, early presentation of a rare seizure type. SPECT scanning confirmed the intrinsic epileptogenesis of the hamartoma, further justifying a surgical approach to such patients. Early surgical intervention is probably indicated in an attempt to minimize or prevent the cognitive and behavioral sequelae commonly seen with this seizure type.
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keywords = respiration
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2/8. Massive air embolism in a neonate with respiratory distress.

    The occurrence of massive air embolism in a neonate during treatment with intermittent positive-pressure respiration and positive end expiratory pressure is reported as a note of caution. It is possible that this complication may indeed be more common. Careful post-mortem examinations (including radiological examinations) are advocated in order that the true incidence of this devastating event shall be known.
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keywords = respiration
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3/8. spinal cord injury in the newborn infant.

    Birth injury to the spinal cord secondary to traction forces during delivery is a common but frequently undiagnosed disorder. The injury usually affects the cervicodorsal junction, with both extradural hematoma and direct cord damage at that level. Clinical findings of a paraplegic infant with abdominal breathing are sometimes obscured by secondary pneumonia and/or hypoxia. Radiologic manifestations include a bell shaped chest indicative of loss of the external muscles of respiration; spinal roentgenograms are usually normal. myelography in neonatal spinal injury demonstrates a block in the subarachnoid space; infrequently localized cord atrophy may be identified.
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keywords = respiration
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4/8. Nasal continuous positive airway pressure in the treatment of whooping cough.

    A 3-week-old baby, suffering from whooping cough with severe attacks of apnoea and hypoxia, was treated by nasal CPAP with a positive airway pressure of about 5 cm H2O. The respiration improved rapidly and the transcutaneous oxygen tension increased to a normal level. The treatment was carried on for 7 days and discontinued gradually in the course of 3 days. The child was also treated with pertussis immunoglobulin and erythromycin. The CPAP system employed is easily and rapidly applied and allows normal nursing of the child during the treatment and manual lung physiotherapy in upright position. The treatment probably proved lifesaving.
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keywords = respiration
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5/8. Posterior fossa subdural hematomas in neonates.

    Posterior fossa subdural hematomas in the newborn infant are rare but potentially treatable. The infants are normal after birth, but within days, hydrocephalus hypotonia, and irregular respirations develop. seizures and third nerve pareses are unusual. We report a neonate in whom this process was identified by computerized tomographic brain scan. We also discuss potential misinterpretations of the computerized tomographic brain scan in neonates.
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keywords = respiration
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6/8. Ventilatory studies in two older infants with prolonged apnea.

    Two infants, both born before term, were found apneic, cyanotic and limp at home when they were 9 weeks and 2 weeks old, respectively. Their respiration was monitored in the hospital and found to be remarkably periodic during sleep, and was in one case accompanied by pronounced bradycardia. The periodic breathing and apnea seemed to be caused by a decreased oxygen tension which can induce an instability of the central respiratory control mechanisms.
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keywords = respiration
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7/8. An explanation for failure of impedance apnoea alarm systems.

    24-hour recordings of the ECG and respiration, the latter from an impedance technique, have shown a phenomenon which could account for hitherto unexplained failures of impedance apnoea alarm systems. Whenever apnoea is accompanied by bradycardia there is a pronounced increase in the amplitude of the cardiac impulse on the respiration carrier. This imitates the respiration signal and prevents the alarm from sounding. Conversely, apnoea unaccompanied by bradycardia does not present this problem and is detected by the alarm. If impedance alarm systems are to be used to detect apnoea they must be accompanied by a heart rate (ECG) detector.
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keywords = respiration
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8/8. Large branchiogenic cyst in a neonate producing upper airway obstruction.

    We report on a large branchiogenic cyst in a neonate. The etiology of these cysts is assumed to be of branchial origin because of their communication with the pharynx and their intimate association with the thyroid and thymus glands. This report documents an additional occurrence of this rare lesion. physicians are alerted to the fact that, should massive enlargements and compromise of the respiration be present, external decompression of these cysts is feasible.
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keywords = respiration
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