Exacerbation of preexisting neurological deficits by neuraxial anesthesia: report of 7 cases

Aldrete, J. Antonio; Reza-Medina, Marisela; Daud, O.; Lalin-Iglesias, Silvia; Chiodetti, Gustavo; Guevara, Uriah; Wikinski, Jaime A.; Torrieri, Alberto

doi:10.1016/j.jclinane.2004.08.011

Cited by 15 publications

(7 citation statements)

References 42 publications

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“…Succinylcholine is contraindicated since it may induce hyperkalemia, and there should be caution in the use of non-depolarizing muscle relaxants due to the risk of exaggerated muscle relaxation. The literature sources have not shown whether regional anesthesia exacerbate the neurological symptoms 11 . However, regional anesthesia is not always possible.…”

Section: Discussionmentioning

confidence: 99%

Uso de sugamadex em doença de Strumpell-Lorrain: relato de dois casos

Franco-Hernández¹,

Rodríguez²,

Landázuri³

et al. 2013

Rev. Bras. Anestesiol.

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Content: Strumpell-Lorrain disease -or familial spastic paraplegia (FSP) -is a rare hereditary neurological disorder, mainly characterized by variable degrees of stiffness and weakening of the muscles, with cognitive impairment, deafness, and ataxia in the more severe cases. We describe two female siblings with FSP programmed for cholecystectomy and subtotal colectomy, respectively, and also how we dealt with the anesthetic management in both cases and review the literature on this disease in relation to anesthesia.

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Section: Discussionmentioning

confidence: 99%

Uso de sugamadex em doença de Strumpell-Lorrain: relato de dois casos

Franco-Hernández¹,

Rodríguez²,

Landázuri³

et al. 2013

Rev. Bras. Anestesiol.

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“…Worsening of neurological symptoms in patients with preexisting neural compromise has always been a fear for the neuraxial anesthesia and analgesia performing anesthetist [1–3]. Disorders of the central nervous system such as multiple sclerosis have historically been a relative contraindication to spinal and epidural anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Neurological deficits appearing after spinal or epidural anesthesia have cast additional doubt on the benefit of neuraxial anesthesia in these patients [2, 3]. If administering neuraxial anesthesia to a patient with an underlying neurological disease is puzzling, then the conduct of anesthesia in a patient with preexisting neurological deficit and a combination of four other pathological disorders is undoubtedly challenging.…”

Section: Introductionmentioning

confidence: 99%

A Common Anesthesiology Procedure for a Patient with an Uncommon Combination of Diseases: A Case Report

Tympa

Hassiakos²,

Salakos³

et al. 2012

Case Reports in Anesthesiology

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Administering neuraxial anesthesia to a patient with an underlying neurological disease and a combination of four other pathological disorders can be challenging. We report in this paper the case of a 45-year-old woman with neurological deficit due to ischemic brain infarct, multiple sclerosis, antiphospholipid syndrome, and β-heterozygous thalassemia that was subjected to abdominal hysterectomy and bilateral salpingoophorectomy under epidural anesthesia for ovarian cancer.

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“…42,43 Exacerbation of prior unrecognized or unreported neurological deficits has been reported following spinal/epidural anesthesia. 44 Anesthesia concerns related to prior stroke: Main perioperative concerns are related to either the prior stroke and prolonged debility with its sequelae or with other associated co-morbidities. Major cerebrovascular accident patients with prolonged immobility may have increased risk of aspiration due to impaired swallowing, ineffective cough and reduced gastric emptying, deep venous thrombosis, and pulmonary embolism.…”

Section: Perioperative Concernsmentioning

confidence: 99%

“…Symptoms such as memory lapses, altered emotional behavior, or inability to express may be positive indicators of previous undiagnosed stroke. 44 All the findings must be documented.…”

Section: Assessment Of Neurological Deficit and Recovery In Functionmentioning

confidence: 99%

Anesthesia for Patients with Prior Stroke

Karnik

Jain

2018

Journal of Neuroanaesthesiology and Critical Care

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An increasing number of patients with a prior history of stroke present for various types of surgeries. They have varying degree of neurological disability and associated co-morbidities, which pose challenges for their perioperative management. There is paucity in literature about their management guidelines for noncardiac, noncarotid surgeries. The available literature suggests higher risk of perioperative stroke, postoperative neurological deficits, and other morbidities. Measures to reduce perioperative risks are discussed in this review. Prior optimization by improving modifiable risk factors, choosing appropriate timing of elective surgery, and careful titration of anesthesia and close monitoring are needed.

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Exacerbation of preexisting neurological deficits by neuraxial anesthesia: report of 7 cases

Cited by 15 publications

References 42 publications

Uso de sugamadex em doença de Strumpell-Lorrain: relato de dois casos

Uso de sugamadex em doença de Strumpell-Lorrain: relato de dois casos

A Common Anesthesiology Procedure for a Patient with an Uncommon Combination of Diseases: A Case Report

Anesthesia for Patients with Prior Stroke

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