Anesthetic management for a patient with Jansky-Bielschowsky disease.
OBJECTIVE
To describe the anesthetic management of a patient with Jansky-Bielschowsky disease (JBD), the late infantile form of neuronal ceroid lipofuscinosis, characterized by dementia, severe and drug resistant grand mal, myoclonic seizures, and blindness.


METHODS
A 14-yr-old girl with JBD was scheduled for resection of a gingival tumour and an infected sinus in the sacral area. Her preanesthetic examination revealed extreme muscle atrophy and dementia. Grand mal, myoclonic seizures, and upper airway obstruction were frequent. Following iv induction with thiamylal, anesthesia was maintained with sevoflurane, N(2)O and O(2). Her trachea was intubated without using muscle relaxants. Muscle relaxants were not used during the operation. Apart from an intractable hypothermia, the intraoperative course was uneventful. The emergence of anesthesia was smooth, except for persisting seizures.


CONCLUSIONS
General anesthesia using thiamylal and sevoflurane provided satisfactory conditions during operation in a patient with JBD. Intraoperative hypothermia required particular attention.
Yamada
Yuko
Y
Department of Anesthesiology, Shimane Medical University, Izumo, Japan.
Doi
Katsushi
K
Sakura
Shinichi
S
Saito
Yoji
Y
D000293:Adolescent; D000758:Anesthesia; D005260:Female; D005887:Gingival Neoplasms / Q000601:surgery; D006801:Humans; D007239:Infections / Q000601:surgery; D009472:Neuronal Ceroid-Lipofuscinoses / Q000150:complications*; D012445:Sacrococcygeal Region