Torticollis in Infants with a History of Neonatal Abstinence Syndrome

McAllister, Jennifer; Hall, Eric S.; Hertenstein, Gayle E.R.; Merhar, Stephanie L.; Uebel, P; Wexelblatt, Scott L.

doi:10.1016/j.jpeds.2017.12.009

Cited by 12 publications

(13 citation statements)

References 13 publications

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“…In 1985, PAN was given to a woman who suffered with idiopathic spasmodic torticollis; the gas produced a beneficial effect, indicating a possible under-activity of the opioid system in the condition [71]. It is therefore significant that torticollis was discovered in a cohort of patients suffering from neonatal abstinence syndrome, the majority of cases of which were opioid-induced, and the remainder polydrug induced (which may have included opioids) [72]. These observations strengthen the notion that underactivity of the opioid system is involved in the pathogenesis of torticollis.…”

Section: From 1970 To Presentmentioning

confidence: 99%

Mini-Review: A Brief History of Nitrous Oxide (N2O) Use in Neuropsychiatry

Gillman

2019

CDRR

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Background: Joseph Priestley’s discovery of nitrous oxide (N2O) was recorded in 1772. In the late 1790’s, Humphry Davy experimented with the psychotropic properties of N2O, describing his observations in a book, published in 1800. A dentist, Horace Wells discovered anaesthesia with N2O in 1844. Over a century after Davy, its potential usefulness in psychiatry was first recognised. The seminal researches in neuropsychiatry, between 1920 and 1950, mainly used anaesthetic concentrations of the gas. The psychotropic actions of N2O, at non-anaesthetic doses, were first used by dentists, mainly for its anxiolytic action. In modern dentistry, N2O is always mixed with at least 30% oxygen and titrated to doses rarely exceeding 40% of N2O. At these lower concentrations, untoward effects are almost always avoided, including over-sedation and/or anaesthesia. In the early 1980’s, the low-dose dental titration technique was first used to investigate and treat psychiatric conditions, including substance abuse. Until then, most physicians regarded the gas only as an anaesthetic agent. An exception was obstetricians who used a fixed 50% concentration of N2O diluted with oxygen for analgesia during parturition. In 1994, to clearly distinguish between anaesthetic and non-anaesthetic concentrations (as used in dentistry), the term Psychotropic Analgesic Nitrous oxide (PAN) was introduced. Objective: This paper will give a brief history of the use of the N2O in psychiatry since the psychotropic actions were first recognised in the 18th century until the present. Conclusion: The role of other non- opioid systems, and the extent to which they contribute to the psychotropic properties of N2O, still remains to be established.

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Section: From 1970 To Presentmentioning

confidence: 99%

Mini-Review: A Brief History of Nitrous Oxide (N2O) Use in Neuropsychiatry

Gillman

2019

CDRR

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“…[1][2][3][4] However, infants demonstrating the most severe signs of withdrawal and who receive pharmacotherapy represent only a portion of infants who experience intrauterine opioid exposureapproximately 30%-80%. 5,6 Previous studies have reported increased rates of long-term comorbidities and suboptimal outcomes among children treated for NAS including diagnoses of developmental delay, behavioral and cognitive problems, [7][8][9][10][11][12] motor problems, [13][14][15] torticollis and plagioce-phaly, 16 ocular comorbidities, 17,18 otitis media, 14 and exposure to the hepatitis C virus (HCV). 19 Risk of poor long-term outcomes among opioid exposed infants who experience less severe withdrawal signs or who do not receive pharmacotherapy has not been well characterized.…”

Section: Introductionmentioning

confidence: 99%

Developmental Disorders and Medical Complications Among Infants with Subclinical Intrauterine Opioid Exposures

Hall

McAllister

Wexelblatt

2019

Population Health Management

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The objective was to compare diagnosis rates representing developmental outcomes and medical complications between infants with intrauterine opioid exposures who did not receive pharmacologic treatment for neonatal abstinence syndrome at the time of birth and infants for whom no exposure to substances of abuse were detected. This retrospective, descriptive study included approximately 95% of Hamilton County, Ohio resident births in 2014 and 2015. Universal maternal drug test results, performed at the time of birth, were documented and linked to electronic health records representing pediatric primary and subspecialty follow-up care as well as urgent care, emergency care, and inpatient services provided by Cincinnati Children's Hospital Medical Center through 2017, when all children were at least 24 months old. Diagnosis rates were compared between drug exposure groups using chi-square tests. Among infants born at >34 weeks gestation and without other complex clinical conditions, infants with subclinical opioid exposures (N = 473) were more likely than infants with no drug exposures (N = 14,933) to be diagnosed with behavioral or emotional disorders (3.0% vs 1.1%, P = 0.0008), developmental delay (15.6% vs 7.6%, P < 0.0001), speech disorder (10.1% vs 6.5%, P = 0.001), or strabismus (3.4% vs 1.0%, P < 0.0001), and more likely to be exposed to the hepatitis C virus (6.8% vs 0.1%, P < 0.0001). Increased diagnosis rates among all opioid exposed infants, regardless of withdrawal severity, may warrant the additional allocation of resources for screening and follow-up. Awareness of the increased risk for certain developmental delays and medical conditions is critical to early intervention and treatment supporting improved outcomes.

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“…Of the 5865 titles identified from searches, 581 full texts were assessed for eligibility, 15 eligible studies were identified, and six were amenable to meta-analysis (Figure 2). (11,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) This represented 10,907 children with a history of NAS and 1,730,213 unexposed children (Table 5; available at www.jpeds.com). (11,(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42) Multiple publications from the same cohort were clarified, to avoid duplication of cases in the statistical analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Studies were retrospective cohort studies (n=8), (11, 29, 35-37, 39, 40, 42) prospective cohort studies (n=1), (33) and case series (n=6). (30-32, 34, 38, 41) Eight studies were deemed to be overall good quality, (11,(32)(33)(34)(35)(36)(37)39) 4 were deemed fair, (29)(30)(31)41) and three poor (Table 6; available at www.jpeds.com). (38,40,42) Included studies were published between 2003-2019 with infants born between 1998 and 2016.…”

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Childhood Health and Educational Outcomes After Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis

Rees

Stilwell

Bolton

et al. 2020

The Journal of Pediatrics

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Torticollis in Infants with a History of Neonatal Abstinence Syndrome

Cited by 12 publications

References 13 publications

Mini-Review: A Brief History of Nitrous Oxide (N2O) Use in Neuropsychiatry

Mini-Review: A Brief History of Nitrous Oxide (N2O) Use in Neuropsychiatry

Developmental Disorders and Medical Complications Among Infants with Subclinical Intrauterine Opioid Exposures

Childhood Health and Educational Outcomes After Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis

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