Wei Shyan Siow1, Wan-Ling Alyssa Chiew2. 1. Changi General Hospital, Singhealth. 2 Simei Street 3, 529889, Singapore, Singapore. swshyan@gmail.com. 2. National Healthcare Group (NHG) Anaesthesiology Residency, 11 Jalan Tan Tock Seng, 308433, Singapore, Singapore.
Abstract
BACKGROUND: Paramyotonia congenita is a rare autosomal dominant myopathy which presents with periodic weakness due to cold and exercise. It is caused by mutations of the SCN4 gene which encodes the sodium channel in skeletal muscles. CASE PRESENTATION: We report a full term obstetric patient with both paramyotonia congenita and terminal filum lipoma who presents for induction of labour followed by an emergency caesarean section performed under epidural anesthesia. Her recovery is subsequently complicated by a 3-day history of postpartum paraparesis attributed to hypokalemic periodic paralysis. CONCLUSION: We describe the perioperative anesthesia considerations and challenges in this case with a review of the current literature. This case report highlights the importance of early proactive and collaborative multidisciplinary approach, maintaining normal temperature and electrolytes with a heightened vigilance for muscle-related perioperative complications.
BACKGROUND: Paramyotonia congenita is a rare autosomal dominant myopathy which presents with periodic weakness due to cold and exercise. It is caused by mutations of the SCN4 gene which encodes the sodium channel in skeletal muscles. CASE PRESENTATION: We report a full term obstetric patient with both paramyotonia congenita and terminal filum lipoma who presents for induction of labour followed by an emergency caesarean section performed under epidural anesthesia. Her recovery is subsequently complicated by a 3-day history of postpartum paraparesis attributed to hypokalemic periodic paralysis. CONCLUSION: We describe the perioperative anesthesia considerations and challenges in this case with a review of the current literature. This case report highlights the importance of early proactive and collaborative multidisciplinary approach, maintaining normal temperature and electrolytes with a heightened vigilance for muscle-related perioperative complications.
Entities:
Keywords:
Caesarean; Case Report; Epidural; Paramyotonia congenita; Terminal Filum Lipoma
Authors: Michael J Cools; Wajd N Al-Holou; William R Stetler; Thomas J Wilson; Karin M Muraszko; Mohannad Ibrahim; Frank La Marca; Hugh J L Garton; Cormac O Maher Journal: J Neurosurg Pediatr Date: 2014-03-14 Impact factor: 2.375
Authors: Jeffrey M Statland; Bertrand Fontaine; Michael G Hanna; Nicholas E Johnson; John T Kissel; Valeria A Sansone; Perry B Shieh; Rabi N Tawil; Jaya Trivedi; Stephen C Cannon; Robert C Griggs Journal: Muscle Nerve Date: 2017-11-29 Impact factor: 3.217