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General anaesthesia for caesarean section in a patient with neuromyelitis optica spectrum disorder (NMOSD)

INTRODUCTION: Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating disorder affecting the spinal cord and optic nerves. The anesthetic management in parturient women with NMOSD are controversial and remains challenging. PRESENTATION OF CASE: A 35-year-old G2P1 woman at 36 weeks of...

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Detalles Bibliográficos
Autores principales: Dusitkasem, Sasima, Subsoontorn, Pattika
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6580010/
https://www.ncbi.nlm.nih.gov/pubmed/31207529
http://dx.doi.org/10.1016/j.ijscr.2019.03.057
Descripción
Sumario:INTRODUCTION: Neuromyelitis optica spectrum disorder (NMOSD) is a rare demyelinating disorder affecting the spinal cord and optic nerves. The anesthetic management in parturient women with NMOSD are controversial and remains challenging. PRESENTATION OF CASE: A 35-year-old G2P1 woman at 36 weeks of gestation with NMOSD presented for pre-anesthesia assessment prior to caesarean section. Her NMOSD had been diagnosed four years previously and was treated with intravenous methylprednisolone (IVMP) and plasma exchange (PLEX). She underwent general anesthesia without developing adverse respiratory events or signs and symptoms of muscle weakness. DISCUSSION: Both neuraxial and general anaesthesia for NMOSD have been described in previous case reports. Risk factors of general anesthesia in pregnancy with NMOSD must be weighed against the likely risk of NMOSD relapse and the potential deteriorating neurological symptoms after neuraxial anesthesia. CONCLUSION: A multidisciplinary collaboration together with careful anesthetic consideration is required for the anesthetic and perioperative management of these patients.