Isoflurane, sold under the brand name Forane among others, is a general anesthetic. It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia rather than isoflurane, due to airway irritation with isoflurane. Isoflurane is given via inhalation.Side effects of isoflurane include a decreased ability to breathe (respiratory depression), low blood pressure, and an irregular heartbeat. Serious side effects can include malignant hyperthermia or high blood potassium. It should not be used in patients with a history of malignant hyperthermia in either themselves or their family members. It is unknown if its use during pregnancy is safe for the fetus, but use during a cesarean section appears to be safe. Isoflurane is a halogenated ether.Isoflurane was approved for medical use in the United States in 1979. It is on the World Health Organizations List of Essential Medicines. Medical uses
Isoflurane is always administered in conjunction with air or pure oxygen. Often, nitrous oxide is also used. Although its physical properties imply that anaesthesia can be induced more rapidly than with halothane, its pungency can irritate the respiratory system, negating any possible advantage conferred by its physical properties. It is used in general anesthesia in tandem with or alternatively to other anesthetic drugs, such as thiopentone or propofol. Adverse effects
Animal studies have raised safety concerns of certain general anesthetics, in particular ketamine and isoflurane, in young children. The risk of neurodegeneration was increased in combination of these agents with nitrous oxide and benzodiazepines such as midazolam.
Jugular foramen syndrome, or Vernets syndrome, is characterized by paresis of the glossopharyngeal, vagal, and accessory (with or without the hypoglossal) nerves. Symptoms
Symptoms of this syndrome are consequences of this paresis. As such, an affected patient may show:
dysphonia/hoarseness
soft palate dropping
deviation of the uvula towards the normal side
dysphagia
loss of sensory function from the posterior 1/3 of the tongue (CN IX)
decrease in the parotid gland secretion (CN IX)
loss of gag reflex
sternocleidomastoid and trapezius muscles paresis (CN XI)

Causes
Glomus tumors (most frequently)
Meningiomas
Schwannomas (Acoustic neuroma)
Metastatic tumors located at the cerebellopontine angle
Trauma
Fracture of occipital bone
Infections
Cholesteatoma (very rare)
Obstruction of the jugular foramen due to bone diseases
Nasopharyngeal carcinoma spreading into the parapharyngeal space involving the ninth, tenth, and eleventh cranial nerves

Diagnosis
Gadolinium enhanced mri for vestibular schwannoma
mri and biopsy for nasopharyngeal carcinoma
based on nerve palsies
NCCT for occipital bone fracture


== References ==