Browsing by Author "Lacassie, HJ"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Dural ectasia: a likely cause of inadequate spinal anaesthesia in two parturients with Marfan's syndrome
    (ELSEVIER SCI LTD, 2005) Lacassie, HJ; Millar, S; Leithe, LG; Muir, HA; Montana, R; Poblete, A; Habib, AS
    We report two cases of Caesarean section in patients with Marfan's syndrome where continuous subarachnoid anaesthesia failed to provide an adequate surgical block. This was possibly because of dural ectasia, which was confirmed by a computed tomography scan in both cases.
  • No Thumbnail Available
    Item
    Reversible nitrous oxide myelopathy and a polymorphism in the gene encoding 5,10-methylenetetrahydrofolate reductase
    (2006) Lacassie, HJ; Nazar, C; Yonish, B; Sandoval, P; Muir, HA; Mellado, P
    We present a case of a patient who received nitrous oxide on two occasions within a period of 8 weeks and who subsequently developed a diffuse myelopathy, characterized by upper extremity paresis, lower extremity paraplegia and neurogenic bladder. Laboratory testing revealed hyper-homocysteinaemia and low levels of vitamin B-12. Because of this uncommon clinical presentation, we analysed the patient's DNA, and found a polymorphism in the MTHFR gene that is associated with the thermolabile isoform of the 5,10-methylenetetrahydrofolate reductase enzyme, which explained the myelopathy experienced by the patient after being exposed to nitrous oxide. Soon after initiating supplementary therapy with folic acid and vitamin B12, the neurological symptoms subsided.