Pediatric neuroscience
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Pediatric neuroscience · Jan 1989
Use of epidural morphine for control of postoperative pain in selective dorsal rhizotomy for spasticity.
Postoperative pain control can be a major problem after selective dorsal rhizotomy for the treatment of spasticity. We report the use of epidural morphine delivered via a catheter placed at surgery for postoperative analgesia in 28 consecutive patients undergoing this procedure. ⋯ There were no instances of respiratory depression, wound infection, or central nervous system depression, and the patients were easily mobilized in the early postoperative period. Epidural morphine is concluded to be a safe and very efficacious method of analgesia after selective dorsal rhizotomy.
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The Dandy-Walker syndrome is said to be associated with a high incidence of mental retardation and motor dysfunction leading some to suggest termination of the affected fetus in utero. Since this view seemed contrary to our experience, we reviewed 19 patients with the Dandy-Walker syndrome diagnosed from 1966 to 1983. Thirteen patients with Dandy-Walker syndrome were diagnosed before 6 months of age and followed for more than 2 years (mean: 10 years). ⋯ In the remaining 4 patients with Dandy-Walker-associated abnormalities, 3 (75%) have severe intellectual retardation and spastic cerebral palsy. Five of six patients (83%) with Dandy-Walker syndrome diagnosed after 6 months of age are normal. The outcome of patients with Dandy-Walker syndrome appears far better than previously reported.
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Pediatric neuroscience · Oct 1986
Comparative StudyHaloperidol, fluphenazine and clonidine in Tourette syndrome: controversies in treatment.
The value of haloperidol, fluphenazine and clonidine as therapeutic agents for Tourette's syndrome was retrospectively reviewed. Haloperidol improved tic symptoms in 50/60 patients, but side effects often nullified these benefits. ⋯ Clonidine was helpful in 47% and caused few side effects. These results support the use of clonidine for the treatment of tics and suggest that fluphenazine can be considered an alternative to other neuroleptic drugs.