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Down Syndrome: A Case Study

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Introduction
Anesthesia providers can expect to encounter patients with Down syndrome multiple times throughout their careers. It is the most common chromosomal disorder, occurring in approximately 1 in every 800 live births and patients with Down syndrome are living longer than at any other point in history.1,2 Skillful anesthetic management presents a unique challenge to the provider. There is no single way to provide anesthetic care to the patient with Down syndrome as the disorder affects multiple organ systems with considerable variability among patients. Therefore, an understanding of the clinical findings of the disorder along with the anesthetic implications associated with these findings are requisite to forming an individualized anesthetic plan based on a thorough preoperative assessment.
Historical Context
Down syndrome was first recognized in medical literature as a distinct disorder in 1862 by John Langdon Down.3 At that time, research in this field was just beginning and individuals with cognitive impairments were not typically differentiated from one another based on medical diagnoses.4 John Langdon Down was the Medical Superintendant of the Royal Earlswood Asylum for Idiots in Redhill, England. The Asylum was among the first to differentiate those with …show more content…

In 90% of cases there is an extra whole chromosome resulting in 47 total chromosomes, instead of the usual 46. In the other 5% of cases, the long arm of chromosome 21 is translocated and attached to another chromosome (most commonly chromosome 14). Such individuals are considered to only have 46 total chromosomes and may have normal cognitive and physical functioning although the anomaly can still result in physiological defects. R1 The abnormal cell division that occurs in utero has no definitive environmental cause although the incidence rises substantially with increasing maternal age.REF?

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