Tuberous Sclerosis Presenting for Laparotomy

Ong, E. L.; Koay, C. K.

doi:10.1177/0310057x0002800119

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…It is also crucial to continue anticonvulsive therapy perioperatively. 17 Cerebral lesions are reported in more than 70% of patients affected by TS, but those in the spinal cord are rare. [18][19][20] There may be leptomeningeal dissemination in low-grade gliomas or metastases of sub-ependymal giant cell astrocytomas.…”

Section: Discussionmentioning

confidence: 99%

Labor analgesia and cesarean section in women affected by tuberous sclerosis: report of two cases

Causse-Mariscal

Palot

Visseaux

et al. 2007

International Journal of Obstetric Anesthesia

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Section: Discussionmentioning

confidence: 99%

Labor analgesia and cesarean section in women affected by tuberous sclerosis: report of two cases

Causse-Mariscal

Palot

Visseaux

et al. 2007

International Journal of Obstetric Anesthesia

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“…Rhabdomyomas, causing severe arrhythmias or heart failure, may require cardiac surgery [39,40]. Sedation [42,43], general anaesthesia [39,40,[44][45][46][47][48][49][50] and regional anaesthesia [40,44,51,52] have all been used in patients with TSC. Shenkman et al studied retrospectively 24 paediatric patients who received 52 general anaesthetics, while epidural anaesthesia was performed in two cases [40].…”

Section: Tuberous Sclerosismentioning

confidence: 99%

Perioperative management of patients with genetic multisystem diseases associated with pre‑excitation

Staikou

Stamelos

Stavroulakis

2019

ait

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Pre-excitation is associated with life-threatening arrhythmias. Apart from the well-known Wolff-Parkinson-White syndrome, a number of rare diseases are associated with pre-excitation due to the existence of accessory pathways. The present review aims to focus on anaesthesia and perioperative care of patients with rare genetic diseases associated with pre-excitation due to the existence of a bundle of Kent or other accessory pathways. The Danon disease, Fabry disease and Pompe disease, tuberous sclerosis, Leber hereditary optic neuropathy (LHON), and mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS) syndrome are genetic multisystem disorders which may involve pre-excitation, usually combined with cardiomyopathy. The anaesthetic management of the above syndromes may become quite challenging. We conducted a PubMed and manual literature search for all types of relevant publications; we identified 58 articles suitable to be included in the present review. According to the literature, a high index of suspicion for the possibility of pre-excitation is required, and anaesthetic drugs and adjuvants should be chosen carefully, in order to prevent or at least not facilitate arrhythmias associated with accessory pathways. The perioperative management should be further tailored to the specific abnormalities of each condition. Multidisciplinary consultation and care, according to the affected organs, are mandatory for a safe outcome. The anaesthetic plan should be focused on preoperative clinical optimization and on case-specific management, tailored to the various systems involved.

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“…The anesthetic management of patients with tuberous sclerosis has only been reported in a total of eight patients in seven published reports [1,[13][14][15][16][17][18], four of which were in non-English-language journals. None of them referred to a patient undergoing renal transplantation.…”

Section: Introductionmentioning

confidence: 99%

Anesthetic management of a patient with tuberous sclerosis presenting for renal transplantation

Papaioannou

Staikou

Lambadariou

et al. 2003

Journal of Anesthesia

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We report one case of anesthetic management of a patient with tuberous sclerosis undergoing renal transplantation. Case reportA 36-year-old woman (160 cm, 56 kg) with tuberous sclerosis, diagnosed 6 years previously, was scheduled for living-donor renal transplantation. The patient had suffered from chronic renal failure for 6 years; the renal parenchyma was replaced by bilateral angiomyolipomas. Four years previously, she underwent unilateral (left) nephrectomy because of massive hematuria and uncontrolled bleeding, but she did not require dialysis. Her blood urea nitrogen was 30 mg·dl Ϫ1 (21 mmol·l Ϫ1 ) and her serum creatinine was 5.4 mg·dl Ϫ1 (480 µmol·l Ϫ1 ).Three times during the past 15 years she had had spontaneous pneumothorax; the last time (10 years previously) she underwent right pleurodesis. After both surgical operations, she was admitted to the intensive care unit (ICU) for routine postoperative management. Her recovery after the nephrectomy was uneventful, and she returned to the ward on the second postoperative day. After the pleurodesis, her stay in the ICU was prolonged to 2 weeks because of a pulmonary infection.She suffered from petit mal seizures between the ages of 3 and 6 years but had no mental retardation. She was a regular smoker (10 packet-years). She was not under regular medical treatment and had no history of drug allergy. The nephrologists suggested that she should have one session of hemodialysis 12 h before operation. Preoperative physical examination disclosed facial angiofibroma over the cheeks and nose and subungual fibromas and shagreen patch (leathery thickening patch) over the lumbosacral region. Her muscle tone and reflexes in all limbs were normal. Physical examination of the respiratory and cardiovascular system was

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Tuberous Sclerosis Presenting for Laparotomy

Cited by 8 publications

References 14 publications

Labor analgesia and cesarean section in women affected by tuberous sclerosis: report of two cases

Labor analgesia and cesarean section in women affected by tuberous sclerosis: report of two cases

Perioperative management of patients with genetic multisystem diseases associated with pre‑excitation

Anesthetic management of a patient with tuberous sclerosis presenting for renal transplantation

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