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Biomedical subjects

A S Christian

Publications and source records attributed to A S Christian.

7 recordsLinked to original sources

Pregnancy, anaesthesia and Guillain Barré syndrome.

Two case histories of pregnant women with Guillain Barré syndrome (acute demyelinating polyradiculoneuritis) are reported. The first required anaesthesia during the second trimester for a minor surgical procedure. The second woman was admitted to the Intensive Care Unit in the first trimester and was ventilated for 18 weeks. Both babies were carried to term and delivered by Caesarean section. A review of the management of Guillain Barré syndrome in pregnancy discusses anaesthetic management, intensive care and the use of plasmapheresis and gamma-globulins. The care of pregnant women recovered from Guillain Barré syndrome is also discussed.

Adult↗

Clinical presentation of suspected malignant hyperthermia during anaesthesia in 402 probands.

As anaesthetists have become more aware of malignant hyperthermia the mortality rate has fallen, but concommitantly the number of dubious and aborted cases has increased. All probands who developed a suspected malignant hyperthermia reaction during anaesthesia and subsequently underwent muscle biopsy were classified according to the clinical presentation. A probability for malignant hyperthermia can be calculated, using the classification, for each type of clinical presentation; this varied from 0.96 to 0.07. Certain clinical features were found to be of more value as predictors than others; these included a high creative kinase and myoglobinuria. The accuracy of prediction depends on a clear contemporaneous description of the clinical events.

Adolescent↗

Is there a relationship between masseteric muscle spasm and malignant hyperpyrexia?

The occurrence of masseteric muscle spasm (MMS) in children is thought to be frequent and to be associated usually with malignant hyperpyrexia (MH). We have found a lower incidence of MMS in children and 50% had no muscle abnormality. Clinical features that support a diagnosis of MH include high serum creatine kinase (CK) concentration and the presence of myoglobinuria. There is evidence to suggest that suxamethonium does increase jaw tone in adults and children, and an exaggerated response may be taken clinically to be MMS. However, MMS should still be regarded as an early warning sign of MH.

Adolescent↗