1/14. Neuromyotonia: an unusual presentation of intrathoracic malignancy.A 48 year old woman is described who presented with increasing muscular rigidity and who was found to have a mediastinal tumour. Electrophysiological studies revealed that the muscular stiffness resulted from very high frequency motor unit activity which outlasted voluntary effort, and which was abolished by nerve block. The abnormal activity may have arisen at the anterior horn cell level. Marked improvement followed the administration of diphenylhydantoin.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
2/14. Three cases with different presentation of fentanyl-induced muscle rigidity--a rare problem in intensive care of neonates.We report about two newborns with sudden onset of inability of mechanical ventilation due to transient chest wall rigidity after fentanyl i.v. bolus of 2 and 4 microg/kg, respectively, resulting in severe hypoxemia and secondary bradycardia. A third case developed a rigidity of the tongue after fentanyl bolus, which created some unusual difficulties in bypassing the tongue for insertion an endotracheal tube. Because of common usage of this agent for analgesia we direct attention to the possibility of fentanyl-induced muscle rigidity. We underline the necessity of a slow bolus injection to prevent this dangerous adverse effect and we recommend the administration of naloxone and/or muscle relaxants as therapy in conjunction with mechanical ventilation.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
3/14. Neonatal chest wall rigidity following the use of remifentanil for cesarean delivery in a patient with autoimmune hepatitis and thrombocytopenia.Remifentanil is a useful adjunct in general anesthesia for high-risk obstetric patients. It provides effective blunting of the rapid hemodynamic changes that may be associated with airway manipulation and surgical stimulation. There have been no previous reports of opioid-related rigidity in the neonate delivered by a parturient receiving intraoperative remifentanil. We present a case of short-lived neonatal rigidity and respiratory depression following remifentanil administration during cesarean section to a parturient with autoimmune hepatitis complicated by cirrhosis, esophageal varices and thrombocytopenia.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
4/14. succinylcholine-induced masseter muscle rigidity during bronchoscopic removal of a tracheal foreign body.masseter muscle rigidity during general anesthesia is considered an early warning sign of a possible episode of malignant hyperthermia. The decision whether to continue or discontinue the procedure depends on the urgency of the surgery and severity of masseter muscle rigidity. Here, we describe a case of severe masseter muscle rigidity (jaw of steel) after succinylcholine (Sch) administration during general anesthetic management for rigid bronchoscopic removal of a tracheal foreign body. anesthesia was continued uneventfully with propofol infusion while all facilities were available to detect and treat malignant hyperthermia.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
5/14. Post-operative rigidity after fentanyl administration.A case of thoraco-abdominal rigidity leading to respiratory failure is described in the post-operative period in an elderly patient who received a moderate dose of fentanyl. This was successfully reversed by naloxone. The mechanisms possibly implicated in this accident are discussed.- - - - - - - - - - ranking = 4keywords = administration (Clic here for more details about this article) |
6/14. A case of neuroleptic malignant syndrome successfully treated with amantadine.A paranoid schizophrenic patient developed the neuroleptic malignant syndrome after receiving three doses of fluphenazine HCl and two doses of thioridazine while he was recovering from major trauma. Treatment with diphenhydramine and benztropine mesylate was ineffective. Administration of amantadine HCl resulted in resolution of all symptoms within 24 hours. After 2 days, the amantadine was discontinued. The following day, the neuroleptic malignant syndrome appeared. Readministration of amantadine again resulted in prompt remission of symptoms.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
7/14. Antibiotic induced meningitis.Three patients with antibiotic induced meningitis, one following penicillin with seven episodes, are reported on--the first well documented description of penicillin induced meningitis. In this patient episodes of headache and nuchal rigidity appeared with and without CSF pleocytosis. Two patients had a total of five episodes of antibiotic induced meningitis after trimethoprim-sulphamethoxazole (co-trimoxazole) administration. The features common to all three patients were myalgia, confusion and low CSF glucose. CSF analysis was not a reliable method to differentiate antibiotic induced meningitis from partially treated bacterial meningitis.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
8/14. Botulinum toxin-A improves the rigidity of progressive supranuclear palsy.Botulinum toxin-A (botox) can improve spasticity and decrease painful spasms in the affected limbs of patients with multiple sclerosis. We report significant improvement of muscle rigidity in the upper limbs after focal administration of botulinum toxin A to 2 patients with progressive supranuclear palsy.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
9/14. Successful treatment of an episode of malignant hyperthermia using a large dose of dantrolene.This clinical case report describes the use of extremely high doses of dantrolene in the management of an episode of malignant hyperthermia (MH). A 6-year-old, 25 kg girl underwent anesthetic induction with halothane for an elective inguinal herniorrhaphy. Tachydysrhythmias, laryngospasm, opisthotonos, rhabdomyolysis, and profound metabolic acidosis ensued as features of an MH crisis. Initial dantrolene administration did not alleviate the symptoms. Increasing doses of dantrolene eventually totaling 42 mg/kg, along with symptomatic supportive care, were administered successfully to treat the event. It is postulated that the severe muscle rigidity may have precluded the circulation of dantrolene to its site of action. The role of the malignant hyperthermia association of the United States (MHAUS) Hotline as a 24-hour consultative service is noted.- - - - - - - - - - ranking = 1keywords = administration (Clic here for more details about this article) |
10/14. Prolonged muscle rigidity following administration of succinylcholine.succinylcholine should be avoided in any patient with known myotonia because of the possibility of an abnormal rigid response. In addition, the possibility of undiagnosed myotonia should be considered in any myopathic patient. While not all myotonic responses are associated with malignant hyperthermia, the anesthetic should be discontinued immediately and the patient should be closely observed for elevation of temperature.- - - - - - - - - - ranking = 4keywords = administration (Clic here for more details about this article) |
| | Next -> |