在新陈代谢的先天性错误中的婴儿:诊断和治疗方面的考虑
Ersida Buraniqi1, Hsuan-Tung Lee2, Kuntal Sen2
1Department of Neurology, Children's National Hospital, Washington, DC, USA.
Journal of child neurology
|November 12, 2025
概括
患有代谢障碍的婴儿发作综合征 (IES) 需要量身定制的治疗. 管理这些复杂的病例需要解决和潜在的代谢脆弱性,以改善结果.
科学领域:
- 神经学 神经学
- 代谢障碍 代谢障碍 代谢障碍
- 遗传学 是一个遗传学.
背景情况:
- 婴儿发作综合征 (IES) 是一种严重的早期发作的脑病.
- IES与代谢天生的错误 (IEM) 之间的联系经常被忽视.
- 代谢失补偿使得受影响婴儿IES的治疗策略复杂化.
研究的目的:
- 为两名IES和IEM患者提供个性化的治疗方法.
- 要突出在与代谢脆弱性同时发生时IES管理的挑战.
主要方法:
- 病例报告详细介绍了两名患有IES和被诊断为IEM的患者.
- 使用的药理和外科干预的描述.
- 控制和代谢状态的监测.
主要成果:
- 患者1 (propionic acidemia) 在肝移植和vigabatrin启动后实现了无发作.
- 患者2 (甲酸转糖酶缺乏症) 用维加巴林和 levetiracetam 显示过渡性发作控制,随后用肠道普雷迪尼索隆停止.
结论:
- 在IEM患者中管理IES是复杂的,需要个性化治疗策略.
- 早期识别和管理代谢障碍对于IES的成功治疗至关重要.
- 多学科护理对于优化这些高风险婴儿的治疗结果至关重要.
相关概念视频
Inborn Errors of Metabolism
688
Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
688
Skeletal Muscle Relaxants: Therapeutic Uses
869
Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
869
Spasmolytic Agents: Chemical Classification
1.3K
Spasmolytic agents are drugs used to alleviate muscle spasms and spasticity. They can be categorized into different chemical groups based on their mechanisms of action. Centrally acting spasmolytics primarily affect the spinal cord, while others directly target skeletal muscle cells.
A major class of centrally acting spasmolytics is the α2-agonist, such as tizanidine. These drugs bind to α2-adrenoceptors, inhibiting the release of the excitatory neurotransmitter glutamate. They also...
A major class of centrally acting spasmolytics is the α2-agonist, such as tizanidine. These drugs bind to α2-adrenoceptors, inhibiting the release of the excitatory neurotransmitter glutamate. They also...
1.3K
Pharmacokinetics in Pediatric Patients: Drug Metabolism
182
In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses...
182
Classification of Skeletal Muscle Relaxants
3.0K
Skeletal muscle relaxants are a group of drugs that can reduce muscle stiffness and induce temporary paralysis to relieve pain. These agents can act centrally to reduce muscle tone or spasms in painful conditions such as multiple sclerosis (MS), amyotrophic lateral sclerosis (ALS), or spinal injuries; they are called antispasmodics or spasmolytics.
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
Peripherally acting skeletal muscle relaxants interfere with the neurotransmission at the neuromuscular end plate to induce paralysis during...
3.0K
Centrally Acting Muscle Relaxants: Therapeutic Uses
1.2K
Centrally acting muscle relaxants reduce muscle tone and tension by interfering with the postsynaptic reflexes in the central nervous system.
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
Centrally acting drugs are classified into spasmolytic and antispasmodic drugs. Spasmolytic drugs such as baclofen, diazepam, and tizanidine inhibit spinal motor neurons and decrease muscle tone. Spasmolytic drugs are administered for severe and chronic spasms due to multiple sclerosis, cerebral palsy, stroke, and spinal cord and muscle injuries. However,...
1.2K


