TY - JOUR
T1 - Emergence delirium with transient associative agnosia and expressive aphasia reversed by flumazenil in a pediatric patient
AU - Drobish, Julie K.
AU - Kelz, Max B.
AU - DiPuppo, Patricia M.
AU - Cook-Sather, Scott D.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Multiple factors may contribute to the development of emergence delirium in a child. We present the case of a healthy 12-year-old girl who received preoperative midazolam with the desired anxiolytic effect, underwent a brief general anesthetic, and then exhibited postoperative delirium, consisting of a transient associative agnosia and expressive aphasia. Administration of flumazenil led to immediate and lasting resolution of her symptoms. We hypothesize that γ-aminobutyric acid type A receptor-mediated effects, most likely related to an atypical offset of midazolam, are an important subset of emergence delirium that is amenable to pharmacologic therapy with flumazenil.
AB - Multiple factors may contribute to the development of emergence delirium in a child. We present the case of a healthy 12-year-old girl who received preoperative midazolam with the desired anxiolytic effect, underwent a brief general anesthetic, and then exhibited postoperative delirium, consisting of a transient associative agnosia and expressive aphasia. Administration of flumazenil led to immediate and lasting resolution of her symptoms. We hypothesize that γ-aminobutyric acid type A receptor-mediated effects, most likely related to an atypical offset of midazolam, are an important subset of emergence delirium that is amenable to pharmacologic therapy with flumazenil.
UR - http://www.scopus.com/inward/record.url?scp=84979852567&partnerID=8YFLogxK
U2 - 10.1213/XAA.0000000000000140
DO - 10.1213/XAA.0000000000000140
M3 - Article
C2 - 26035220
AN - SCOPUS:84979852567
SN - 2325-7237
VL - 4
SP - 148
EP - 150
JO - A & A case reports
JF - A & A case reports
IS - 11
ER -