Catalogue Search | MBRL
Are you sure you want to remove the book from the shelf?
{{itemTitle}}
73
result(s) for
"Sheldon, Stephen H"
Sort by:
Cervical spinal cord compression in infants with achondroplasia: should neuroimaging be routine?
Purpose
To examine results of magnetic resonance imaging (MRI), polysomnograms (PSG), and patient outcomes in patients with achondroplasia in light of recent screening recommendations for infants with achondroplasia.
Methods
We reviewed medical records of 49 patients with achondroplasia followed at our institution between September 1997 and January 2017, including physical exams, MRIs, PSGs (when available), and surgical histories. Appropriate PSG data were available for 39 of these patients.
Results
Twenty-seven of 49 patients had cervical cord compression on MRI, and 20 of those patients required surgery. Central apnea was detected in 2/23 patients with cervical cord compression in whom PSG data was available. Physical exam revealed depressed deep-tendon reflexes in two patients with cord compression and one patient without cord compression. Besides hypotonia in some, the neurological exams of these patients were unremarkable.
Conclusions
Cervical cord compression is a common occurrence in infants with achondroplasia and necessitates surgical intervention in some patients. Physical exam and PSG are poor predictors of the presence of cord compression or the need for surgery. All infants with achondroplasia should have MRIs of the craniocervical junction in the first 6 months of life.
Journal Article
Pro-convulsant effects of oral melatonin in neurologically disabled children
Sheldon studied whether melatonin would improve, with minimum side effects, sleep in children with neurological disabilities. Although melatonin had a positive effect on patients' sleep disorders, seizures increased among a number of the children in the study.
Journal Article
Sleep Disorders in Children
During the past 25 years, development of Pediatric and Adolescent Sleep Medicine (PASM) has become an imperative child health care discipline. During the past decade, the American Academy of Sleep Medicine (AASM) prepared a modern path for certification in competency in the practice of Sleep Medicine by the American Board of Medical Specialties (ABMS) by applying for recognition of sleep medicine training programs by the Accreditation Council for Graduate Medical Education (ACGME) and pursuing ABMS approval of the certification process.
Journal Article
Just a Scary Dream? A Brief Review of Sleep Terrors, Nightmares, and Rapid Eye Movement Sleep Behavior Disorder
CME Educational Objectives
1.
Recognize the signs and symptoms of parasomnias in children.
2.
Develop a clinical framework to evaluate common parasomnias in children.
3.
Distinguish the unique features of sleep terrors, nightmares, and rapid eye movement sleep behavior disorder (RBD).
The clinical spectrum of sleep disorders in children is broad, ranging from primary snoring and obstructive sleep apnea (OSA) syndrome to complex sleep-related behaviors and movement disorders. Although snoring and OSA typically receive significant attention and discussion, other biologically based sleep disorders are as common, if not more common, in children. A general pediatrician is frequently presented with the complaint of sleep talking, sleep walking, or abnormal movements during sleep. Even more alarming is the presentation of the child suddenly and explosively screaming during sleep. Such complaints fall under the category of parasomnias. Exclusive to sleep and wake-to-sleep transitions, these parasomnias include arousals with abnormal motor, behavioral, autonomic, or sensory symptoms. Parasomnias can be noticeably dissimilar in clinical manifestations, but most share biologic characteristics. Three parasomnias associated with loud vocalizations associated with sleep that can present to general practitioners include sleep terrors, nightmares, and rapid eye movement sleep behavior disorder (RBD). Although usually benign, these sleep disorders can be disruptive and even potentially dangerous to the patient and can often be threatening to quality of life. In this article, we describe the clinical features of some of these disorders and how to differentiate between their alarming presentations.
Journal Article
Pediatric Obstructive Sleep Apnea: An Update
According to these guidelines, obstructive apnea lasts for at least two respiratory efforts with a greater than 90% fall in nasal pressure signal amplitude for greater than or equal to 90% of the entire respiratory event compared with pre-event baseline amplitude. In the 2005 edition of the International Classification of Sleep Disorders, the AASM defines an AHI greater than 1/hr as abnormal in children, but no studies have clearly demonstrated that specific AHI values correlate closely with morbidity. [...] the AHI and other polysomnographic data require clinical correlation by a physician who understands what information is provided by the PSG and how to apply it to patient care.
Journal Article
REM-Sleep Motor Disorder in Children
In 1986, Schenck and coworkers described REM-sleep behavior disorder as a treatable parasomnia affecting older males. This disorder is characterized by intermittent loss of the muscle atonia, which normally characterizes the rapid eye movement (REM) sleep state. Complex motor behaviors occur that are often injurious and are associated with dreaming. We have identified five children who meet the criteria for REM-sleep behavior disorder and describe the clinical and polysomnographic characteristics of these patients, along with corresponding polysomnographic characteristics of matched comparison subjects. (J Child Neurol 1998; 13:257-260).
Journal Article
