Mesut ERBAŞ, Bekir Sami KARAPOLAT, Burhan DOST

Epidural anesthesia in a patient with Huntington's chorea

Huntington koresi (HK) nadir görülen otozomal dominant geçiş gösteren sinir sistemi bozukluğudur. Semptomları hayatın 3. ve 4. dekatlarında istemsiz koreiform hareketleri, ataksi ve ilerleyici mental bozulma olarak gösterir. HK tanılı olgularda anestezi yönetimi ile ilgili sadece birkaç olgu sunumu yayınlanmıştır. Hastalar bazı intraoperatif komplikasyonlar (regürjitasyon ve pulmoner aspirasyon gibi), zayıf respiratuar fonksiyon, uzamış suksinilkolin ve tiyopental cevabı, midazolama karşı yükselmiş sensitivite, ve rijit spazmlara yol açan titremeler gibi postoperatif komplikasyonlar açısından yüksek risk altındadırlar.Tüm bunlar güvenli geri dönüş ve anestezi sırasında güvenli havayolu sağlamak için ideal anestezi yönetimi gerektirmektedir. Bildiğimiz kadarıyla, literatürlerde HKli hastalarda epidural anestezi uygulanması bulunmamaktadır. Burada, HK tanılı olgumuzda başarılı epidural anestezi deneyimimizi sunmayı amaçladık.

Huntington koresi olan bir hastada epidural anestezi

Huntington's chorea (HC) is a rare, autosomal, dominant hereditary disorder of the nervous system. Symptoms occur in the third and fourth decade of life and manifest as involuntary choreiform movements, ataxia, and progressive mental deterioration. Only a few case reports have been published describing the anesthetic management of patients with HC. Patients are at greater risk for some intraoperative complications (e.g., regurgitation and pulmonary aspiration), poor respiratory function, prolonged response to succinylcholine and thiopental, increased sensitivity to midazolam, and postoperative shivering leading to rigid spasms. All these factors make an ideal anesthesiological management necessary for this group of patients to guarantee an absolute airway protection during all the anesthesia and a fast and safe recovery. To the best of our knowledge, epidural anesthesia in HC patients has not been reported in the literature. Herein, we present our successful experience using epidural anesthesia in a HC patient.

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