Uhthoff’s phenomenon in a patient with multiple sclerosis during the perioperative period for hip surgery. Case report
Abstract
Increase in body temperature is associated with neurological deficit exacerbations in patients with multiple sclerosis (MS). These are corrected with the resolution of hyperthermia, in what is known as Uhthoff's phenomenon. A 65-year-old patient with primary progressive MS, admitted because of hip fracture, developed acute respiratory failure in association with elevation in body temperature (38 °C) due to an increase in room temperature. Additional tests ruled out infection, pulmonary thromboembolism, or other concomitant processes. The patient's respiratory condition improved following a change in room temperature and the use of pharmacological treatment for hyperthermia. She was taken to surgery under general anesthesia 3 days after admission, with tight temperature monitoring, and surgery proceeded uneventfully. Anesthetic management in patients with MS is important, requiring close control of body temperature to avoid comorbidities and perioperative complications.
References
2. Nozari A, Bagchi A, Saxena R. Miller RD, et al. Neuromuscular disorders and other genetic disorder. Miller's anesthesia Vol. 1 8th ed. Churchill Livingstone, New York, NY:2015;1266-1286.
3. Makris A, Piperopoulos A, Karmaniolou I. Multiple sclerosis: basic knowledge and new insights in perioperative management. J Anesth 2014;28:267-278.
4. Opara JA, Brola W, Wylegala AA, et al. Uhthoff s phenomenon 125 years later-what do we know today? J Med Life 2016;9:101-105.
5. Frohman TC, Davis SL, Beh S, et al. Uhthoff s phenomena in MS- clinical features and pathophysiology. Nat Rev Neurol 2013;9:535-540.
6. Perlas A, Chan VW. Neuraxial anesthesia and multiple sclerosis. Can J Anaesth 2005;52:454-458.
7. Quispe Ricci AC. Management of anesthesia during C-section of a multiple sclerosis pregnant woman: Case report and literature review. Rev Colomb Anestesiol 2015;43:104-106.
8. Moreno-Gonzales R, Vásquez-Rojas G, Rojas Fun M. Anesthetic management of a patient diagnosed with amyotrophic lateral sclerosis taken to cesarean section: Case report. Rev Colomb Anestesiol 2017;45:86-89.
9. Dorotta IR, Schubert A. Multiple sclerosis and anesthetic implications. Curr Opin Anaesthesiol 2002;15:365-370.
10. Jeffrey J, Pasternak William L, Lanier JR. Hines RL, Nicolas M, Khatherine E, et al. Diseases affecting the brain. Stoelting's anesthesia and co-existing disease 7th ed. Elvesier, Philadelphia:2018;296-298.
11. Brett RS, Schmidt JH, Gage JS, et al. Measurement of acetylcholine receptor concentration in skeletal muscle from a patient with multiple sclerosis and resistance to atracurium. Anesthesiology 1987;66:837-839.
12. Kaufman J, Khatri BO, Riendl P. Are patients with multiple sclerosis protected from thrombophlebitis and pulmonary embolism? Chest 1988;94:998-1001.
Downloads
Altmetric
| Article metrics | |
|---|---|
| Abstract views | |
| Galley vies | |
| PDF Views | |
| HTML views | |
| Other views | |
