Anesthetic Management of an Obstetric Patient with Behçet’s Disease Complicated by Transverse Myelitis

Abstract

Transverse myelitis is an acute inflammation of the spinal cord. Its annual incidence is 1–8 per million. Behçet disease is also a rare autoimmune disease. Transverse myelitis can be a manifestation of neuro-Behçet’s disease. For those two rare diseases to present in one patient sets a challenge in anesthetic management. Up to our knowledge, our approach to managing these cases has not been reported in the literature. We present the case of a 37-year-old female patient in her 34th week of pregnancy, showing manifestations of neuro-Behçet’s disease and recurrent transverse myelitis. She presented to the preanesthesia clinic on a wheelchair with worsening of baseline right lower limb weakness. The patient elected for neuroaxial anesthesia, and the procedure was conducted without complications. The patient was followed up for 6 months. The neuroaxial approach was successful. Patients with neuro-Behçet’s disease and transverse myelitis can be safely managed with epidural anesthesia.