Sentinel Node Biopsy and Lumpectomy in a Patient with Machado–Joseph Disease

Abstract

Spinocerebellar ataxia 3 (SCA3), also known as Machado–Joseph disease (MJD) is an autosomal dominant, progressive neurodegenerative disorder. Patients present with cerebellar ataxia, dystonia, rigidity, and neuropathy that worsen with time. On a molecular level, it occurs due to a CAG trinucleotide repeat expansion in the ATXN3 gene. Due to the risk of pulmonary aspiration, hypoventilation, autonomic and thermoregulatory dysfunction, vocal cord paralysis, progressive paraplegia, parkinsonian symptoms, and chronic pain, it has significant anesthesia implications. Rarely, case reports occur in the literature describing regional anesthetic management of patients with SCA3, but none that describe general anesthesia specifically with MJD. We therefore describe a case of a patient with SCA3 who successfully underwent general anesthesia and considerations for perioperative management of this patient population.

A Case of Orthognathic Surgery for Jaw Deformity in a Patient with Spinocerebellar Ataxia

“…Although some case reports describe surgery under general anesthesia in patients with SCA, 4 only one case of surgery under general anesthesia in a patient with SCA3 has been reported. 5 Moreover, orthognathic surgery has not been reported in any cases. Regarding orthognathic surgery for SCA3 patients, we should consider two major risks.…”