Biomedical subjects

Tuhin K Roy

Publications and source records attributed to Tuhin K Roy.

3 recordsLinked to original sources

PubMed2006

Cluster breathing associated with bihemispheric infarction and sparing of the brainstem.

OBJECTIVE: To report cluster breathing pattern associated with a nonbrainstem lesion. DESIGN: Case report. SETTING: Neurointensive care unit, St Mary's Hospital, Rochester, Minn. PATIENT: A patient with subarachnoid hemorrhage developed severe, diffuse, distal bilateral middle cerebral artery vasospasm with resultant cortical laminar necrosis and transient cluster breathing. Intervention Magnetic resonance imaging revealed bihemispheric lesions but no brainstem lesion. CONCLUSION: Cluster breathing may occur with nonbrainstem lesions.

Aged↗

PubMed2006

BiPAP in early guillain-barré syndrome may fail.

BACKGROUND: Non-invasive mechanical ventilation (BiPAP) has been introduced for use in neuromuscular respiratory disease such as amyotrophic lateral sclerosis and myasthenia gravis. There is no experience in Guillain-Barré syndrome. METHODS: We describe for the first time the use of BiPAP to assist in the work of breathing in two consecutive patients with progressing Guillain-Barré syndrome (GBS) and marginal pulmonary function. RESULTS: Our initial attempts to use BiPAP in GBS and early neuromuscular respiratory failure were totally unsuccessful. There was marked initial improvement; however, emergency intubation was needed in both patients, one of which became acutely cyanotic. CONCLUSIONS: Until more experience is available, we strongly warn against using BiPAP in deteriorating patients with GBS.

Aged↗

PubMed2006

Prolonged coma from refractory status epilepticus.

OBJECTIVE: Status epilepticus is a life-threatening medical condition. In its most severe form, refractory status epilepticus (RSE) seizures may not respond to first and second-line anti-epileptic drugs. RSE is associated with a high mortality and significant medical complications in survivors with prolonged hospitalizations. METHODS: We describe the clinical course of RSE in the setting of new onset lupus in a 31-year-old male who required prolonged barbiturate coma. RESULTS: Seizure stopped on day 64 of treatment. Prior to the resolution of seizures, discussion around withdrawal of care took place between the physicians and patient's family. Medical care was continued because of the patient's age, normal serial MRI studies, and the patient's reversible medical condition. CONCLUSION: Few evidence-based data exist to guide management of RSE. Our case emphasizes the need for continuous aggressive therapy when neuroimaging remains normal.

Adult↗