title: Treatment with gabapentin associated with resolution of apnea in two infants with neurologic impairment.
abstract: BACKGROUND
  Infants with neurologic impairment (NI) as a result of injury to the central nervous system have a significant rate of pain. Problems associated with pain in children with NI include increased tone. This secondary hypertonia may contribute to apnea as a result of alterations in airway tone and chest wall movement. Infants are at greatest risk given their smaller airways, lower functional residual capacity, and the high rate of unrecognized pain at this age.
  
  
  CONCLUSIONS
  We report two cases of infants with NI, identified to have significant improvement in apnea following empiric treatment with gabapentin for presumed central pain and/or visceral hyperalgesia. This correlation between pain and apnea, with resolution in apnea following effective treatment of these presumed sources, has not been previously reported in the literature.
  
  
  CONCLUSIONS
  Infants with NI and apnea should have careful pain assessment and treatment, when considering other causes and interventions for apnea.
authors.affiliation: Department of General Pediatrics, Children's Hospital Boston, Boston, MA 02115, USA. julie.hauer@childrens.harvard.edu
authors.forename: Julie
authors.initials: J
authors.lastname: Hauer
authors.forename: Daniel
authors.initials: D
authors.lastname: Mackey
mesh_terms: D000588:Amines / Q000627:therapeutic use*; D000700:Analgesics / Q000627:therapeutic use*; D001049:Apnea / Q000209:etiology / Q000517:prevention & control*; D002490:Central Nervous System / Q000293:injuries; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007223:Infant; D009122:Muscle Hypertonia / Q000150:complications; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D000700:Analgesics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin