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Neuropathies are rare in neonates. A bilateral lesion involving either cranial nerve V or XII may produce obstructive apnea. Bilateral phrenic nerve injuries produce central apnea. Bilateral phrenic nerve injury may occur with bilateral brachial plexus injuries. More about...214
Myoneural junction disorders are common in the neonatal period. Botulism and transient myasthenia gravis are the most common neuromuscular disorders that affect the myoneural junction in neonates. Botulism affects the presynaptic area preventing the normal release of acetylcholine. Botulism produces signs of smooth and striated muscle dysfunction. Smooth muscle dysfunction leads to constipation and pupillary abnormalities. Striated muscle dysfunction leads to weakness and hypotonia. Myasthenia gravis is a postsynaptic disease. It affects the nicotinic receptors of the striated muscle. Myasthenia gravis presents with weakness and hypotonia but no evidence of autonomic dysfunction. More about...140
Muscle disease may produce apnea. Neonates with myotonic dystrophy often need prolonged respiratory support in the neonatal period because of frequent apnea. Myotonic dystrophy is diagnosed by shaking hands with the mother. A mother with myotonic dystrophy has difficulty performing maneuvers that require muscle relaxation after a muscle contraction such as releasing one’s hand after a handshake. More about...142


Apneic episodes of nonneurological cause are more frequent than apnea of neurologic origin. Nonneurologic causes of apnea are gastroesophageal reflux, upper airway abnormality, systemic illness, and pulmonary disease.


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Volpe, 1995