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Tendinosis is now understood as the result of a failed tendon healing process regardless of where it occurs in the body. Current noninvasive therapeutic alternatives are anti-inflammatory in nature and outcomes are unpredictable at best. The benefit of invasive alternatives resides in the induction of the healing response as demonstrated in pre-clinical and clinical studies in cardiology and orthopaedics. A new technology that employs noninvasivemonopolar capacitive-coupled radiofrequency (mcRF), has demonstrated the ability to raise temperatures in tendons and ligaments upwards of 50°C, the temperature threshold for collagen modulation and recruitment of macrophages, fibroblasts and Heat Shock Protein factors—without damaging the overlying structures—resulting in activation of the Wound Healing Response (WHR).
Clobazam, a 1-5 benzodiazepine, was introduced
in the 1970s for the treatment of anxiety and agitation. Antiepileptic
properties were recognized, and efficacy in a number of epilepsy syndromes was
demonstrated in humans, with good tolerance. Recent reviews are generally favorable,
with a relative minimum of medication-related side effects. However, a number
of benzodiazepines have been associated with causing hypothermia. To date, this
side effect has not been reported with clobazam. We report two cases of
profound hypothermia associated with the use of this medication for the
treatment of epilepsy. Both children had significant cerebral dysgenesis and
were developmentally impaired, but neither had experienced hypothermia before.
Temperature dysregulation was resolved with medication withdrawal after an
extensive work-up for alternative causes. Hypothermia should
be considered as a possible side effect of clobazam, although the exact
mechanism is unknown. Appropriate monitoring of temperature is appropriate, and
precautions should be offered by caregivers.