Skip to main content
Journal cover image

Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood.

Publication ,  Journal Article
Parker, LE; Wallace, K; Thevathasan, A; Funk, E; Pratt, M; Thamby, J; Tran, L; Prange, L; Uchitel, J; Boggs, A; Minton, M; Jasien, J ...
Published in: Eur J Paediatr Neurol
May 2022

BACKGROUND: Alternating hemiplegia of childhood (AHC) pathophysiology suggests predisposition to sedation and anesthesia complications. GOALS: Hypotheses: 1) AHC patients experience high rates of sedation-anesthesia complications. 2) ATP1A3 mutation genotype positivity, age, and AHC severity correlate with more severe complications. 3) Prior short QTc correlates with cardiac rhythm complications. METHODS: Analysis of 34 consecutive AHC patients who underwent sedation or anesthesia. Classification of complications: mild (not requiring intervention), moderate (intervention), severe (intervention, risk for permanent injury or potential life-threatening emergency). STATISTICS: Fisher Exact test, Spearman correlations. RESULTS: These patients underwent 129 procedures (3.79 ± 2.75 procedures/patient). Twelve (35%) experienced complications during at least one procedure. Fourteen/129 procedures (11%) manifested one or more complications (2.3% mild, 7% moderate, 1.6% severe). Of the total 20 observed complications, six (33.3%) were severe: apneas (2), seizures (2), bradycardia (1), ventricular fibrillation that responded to resuscitation (1). Moderate complications: non-life-threatening bradycardias, apneas, AHC spells or seizures. Complications occurred during sedation or anesthesia and during procedures or recovery periods. Patients with disease-associated ATP1A3 variants were more likely to have moderate or severe complications. There was no correlation between complications and age or AHC severity. Presence of prior short QTc correlated with cardiac rhythm complications. After this series was analyzed, another patient had severe recurrent laryngeal dystonia requiring tracheostomy following anesthesia with intubation. CONCLUSIONS: During sedation or anesthesia, AHC patients, particularly those with ATP1A3 variants and prior short QTc, are at risk for complications consistent with AHC pathophysiology. Increased awareness is warranted during planning, performance, and recovery from such procedures.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Eur J Paediatr Neurol

DOI

EISSN

1532-2130

Publication Date

May 2022

Volume

38

Start / End Page

47 / 52

Location

England

Related Subject Headings

  • Sodium-Potassium-Exchanging ATPase
  • Seizures
  • Neurology & Neurosurgery
  • Humans
  • Hemiplegia
  • Apnea
  • Anesthesia
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Parker, L. E., Wallace, K., Thevathasan, A., Funk, E., Pratt, M., Thamby, J., … Mikati, M. A. (2022). Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood. Eur J Paediatr Neurol, 38, 47–52. https://doi.org/10.1016/j.ejpn.2022.03.007
Parker, Lauren E., Keri Wallace, Arthur Thevathasan, Emily Funk, Milton Pratt, Julie Thamby, Linh Tran, et al. “Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood.Eur J Paediatr Neurol 38 (May 2022): 47–52. https://doi.org/10.1016/j.ejpn.2022.03.007.
Parker LE, Wallace K, Thevathasan A, Funk E, Pratt M, Thamby J, et al. Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood. Eur J Paediatr Neurol. 2022 May;38:47–52.
Parker, Lauren E., et al. “Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood.Eur J Paediatr Neurol, vol. 38, May 2022, pp. 47–52. Pubmed, doi:10.1016/j.ejpn.2022.03.007.
Parker LE, Wallace K, Thevathasan A, Funk E, Pratt M, Thamby J, Tran L, Prange L, Uchitel J, Boggs A, Minton M, Jasien J, Nagao KJ, Richards A, Cruse B, De-Lisle Dear G, Landstrom AP, Mikati MA. Characterization of sedation and anesthesia complications in patients with alternating hemiplegia of childhood. Eur J Paediatr Neurol. 2022 May;38:47–52.
Journal cover image

Published In

Eur J Paediatr Neurol

DOI

EISSN

1532-2130

Publication Date

May 2022

Volume

38

Start / End Page

47 / 52

Location

England

Related Subject Headings

  • Sodium-Potassium-Exchanging ATPase
  • Seizures
  • Neurology & Neurosurgery
  • Humans
  • Hemiplegia
  • Apnea
  • Anesthesia
  • 3213 Paediatrics
  • 3209 Neurosciences
  • 1114 Paediatrics and Reproductive Medicine