Awake apnea associated with gastroesophageal reflux: A specific clinical syndrome

Spitzer, Alan R.; Boyle, John T.; Tuchman, David N.; Fox, William W.

doi:10.1016/s0022-3476(84)80992-0

Cited by 161 publications

(65 citation statements)

References 9 publications

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“…Inhalation of feed or vomit may play a part in sudden infant death 46 and awake apnoea associated with gastro-esophageal reflux is well recognized. 47 The physiological response to aspiration may be dramatic; foreign material on the larynx causes laryngospasm which is associated with startle, cessation of respiration, hypoxaemia, bradycardia, and a doubling of blood flow to the brain. 48 These circumstances with, or even without, vigorous resuscitation, may cause a preexisting healing subdural membrane to bleed or cause the dura itself to become haemorrhagic and ooze blood into the subdural space.…”

Section: The Clinical Historymentioning

confidence: 99%

Shaken baby syndrome: the quest for evidence

Squier

2007

Develop Med Child Neuro

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Shaken baby syndrome (SBS), characterized by the triad of subdural haemorrhage, retinal haemorrhage, and encephalopathy, was initially based on the hypothesis that shaking causes tearing of bridging veins and bilateral subdural bleeding. It remains controversial. New evidence since SBS was first defined three decades ago needs to be reviewed. Neuropathology shows that most cases do not have traumatic axonal injury, but hypoxic–ischaemic injury and brain swelling. This may allow a lucid interval, which traumatic axonal injury will not. Further, the thin subdural haemorrhages in SBS are unlike the thick unilateral space‐occupying clots of trauma. They may not originate from traumatic rupture of bridging veins but from vessels injured by hypoxia and haemodynamic disturbances, as originally proposed by Cushing in 1905. Biomechanical studies have repeatedly failed to show that shaking alone can generate the triad in the absence of significant neck injury. Impact is needed and, indeed, seems to be the cause of the majority of cases of so‐called SBS. Birth‐related subdural bleeds are much more frequent than previously thought and their potential to cause chronic subdural collections and mimic SBS remains to be established.

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Section: The Clinical Historymentioning

confidence: 99%

Shaken baby syndrome: the quest for evidence

Squier

2007

Develop Med Child Neuro

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“…The relationship of GER to respiratory problems, such as persistent wheezing and chronic cough, is well established (3)(4)(5)(6)(7). In infants, studies have suggested a relationship between apnea and GER (8)(9)(10)(11)(12)(13)(14), but the temporal association is still controversial (15)(16)(17). Despite the lack of conclusive evidence, apnea associated with reflux remains a common indication for fundoplication, and this approach is supported by a significant postoperative decrease in the frequency of apneic episodes (18)(19).…”

mentioning

confidence: 99%

“…GER is not only postulated to cause obstructive apnea but is also implicated in central and mixed apnea (11,(20)(21)(22)(23)(24). Apnea may be mediated by distal esophageal afferents and laryngospasm secondary to chemoreflexes (24)(25)(26).…”

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confidence: 99%

Prevalence of Gastroesophageal Reflux in Infants with Recurrent Brief Apneic Episodes

Sheikh

Stephen

Sisson

1999

Canadian Respiratory Journal

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BACKGROUND: Apnea in an infant can be a diagnostic dilemma for the treating pediatrician. It is suggested that in some infants, gastroesophageal reflux (GER) might be a factor in the pathogenesis of apnea, although its role as a cause of apnea is still controversial.OBJECTIVE: To evaluate the prevalence of GER in infants presenting with recurrent brief apneic periods.PATIENTS AND METHODS: A retrospective review of the medical records of all the infants who underwent prolonged esophageal pH studies for brief apneic episodes (n=105) at the Kosair Children’s Hospital in the six years from January 1992 to December 1997 was performed. Infants presenting with apparent life-threatening episodes were excluded.RESULTS: Of 105 infants, 72 (68.6%) were younger than two months of age and 22 (21%) were born preterm. Fifty of 105 infants (47.6%) had positive esophageal pH studies for acid reflux. Among infants with positive pH studies, only 21 (42%) had associated gastrointestinal or feeding complaints.CONCLUSION: GER is present in a large number of infants presenting with brief apneic episodes. Though the relationship between the two is still not fully established, GER may be a significant risk factor for such apneic episodes in infants.

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“…Em crianças de mais idade, a obstrução causada por hipertrofia da amígdala e adenóides, a obesidade e a síndrome de Rett são as causas mais comuns de apnéia, mas outras causas incluem distúrbios neuromusculares, doenças do SNC, encefalomiopatia mitocondrial, encefalopatia familiar com respiração periódica permanente e apnéia central de causa desconhecida 6 . Refluxo gastroesofágico e espasmo esofágico também podem causar apnéia e bradicardia, também conhecida como "a síndrome de apnéia acordada" [104][105][106][107] .…”

Section: Episódios De Apnéia-bradicardia Síndrome Da Morte Súbita Dounclassified

Paroxysmal non-epileptic events

Menezes

2002

J Pediatr (Rio J)

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ResumoObjetivo: este artigo tem como objetivo discutir um dos principais problemas com os quais um pediatra geral tem que lidar no campo da neurologia infantil, que são os distúrbios paroxísticos não-epilépticos. Estes episódios também são uma causa freqüente de consultas aos neuropediatras e de internação em unidades de monitorização por vídeo-eletrencefalograma.Fontes dos dados: revisão da literatura sobre o assunto na Medline. Vários compêndios de neurologia pediátrica também foram usados, por conterem informações importantes sobre o assunto.Síntese dos dados: muitas das entidades discutidas neste artigo são freqüentes na população pediátrica, como, por exemplo, a síncope, as crises de perda do choro, e os movimentos patológicos associados ao refluxo gastroesofágico. Outras entidades são mais raras, como as distonias paroxísticas e a distonia com flutuação diurna.Conclusões: o conhecimento básico das várias síndromes associadas com distúrbios paroxísticos não-epilépticos é extremamente importante para o pediatra geral, porque pode evitar exames desnecessários e o diagnóstico errôneo de epilepsia, expondo as crianças às medicações que não vão melhorar o quadro clínico, e que podem causar efeitos colaterais.J Pediatr (Rio J) 2002; 78 (Supl.1): S73-S88: epilepsia, convulsão, distúrbios paroxísticos não-epilépticos, síncope, distúrbios do movimento, tetania, hiperecplexia, vertigem. AbstractObjective: this article aims at reviewing one of the most important problems faced by pediatricians in the field of child neurology. The paroxystic non-epileptic events are also a frequent reason for pediatric neurology consultations and admission for diagnostic videoelectroencephalogram monitoring.Sources: literature review on the subject was perform on Medline, data were also collected from the main Pediatric Neurology Textbooks, which were found to be an important and unique source of information on the subject.

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Awake apnea associated with gastroesophageal reflux: A specific clinical syndrome

Cited by 161 publications

References 9 publications

Shaken baby syndrome: the quest for evidence

Shaken baby syndrome: the quest for evidence

Prevalence of Gastroesophageal Reflux in Infants with Recurrent Brief Apneic Episodes

Paroxysmal non-epileptic events

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