Anaesthetic management of children with tuberous sclerosis.
BACKGROUND
Tuberous sclerosis (TS) is a hamartomatous disease that usually presents with cutaneous and intracranial lesions, but can also affect other organ systems.


METHODS
In this report, we retrospectively reviewed the perioperative course of 24 children with TS who had medically intractable seizures as the primary disease process.


RESULTS
Cardiac rhabdomyoma was detected in 11 of 18 patients who had a cardiac evaluation, and coexisting congenital heart defects were diagnosed in six. Ten of 17 patients who had a renal evaluation were diagnosed with renal TS, presenting with azotaemia in one and hypertension in four. The major perioperative complications in the 52 anaesthetics, included death (a neonate after cardiac rhabdomyoma resection), seizures (five patients) and bradyarrhythmias (two patients).


CONCLUSIONS
Patients with TS and neurological disorders frequently have coexisting cardiac and renal disease as well. Patients with TS should be evaluated for these organ specific disorders prior to surgery.
Shenkman
Ze'ev
Z
Department of Anaesthesia, Children's Hospital, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. shlomsh@netvision.net.il
Rockoff
Mark A
MA
Eldredge
Elizabeth A
EA
Korf
Bruce R
BR
Black
Peter Mch L
PM
Soriano
Sulpicio G
SG
D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D002648:Child; D002675:Child, Preschool; D005260:Female; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009422:Nervous System Diseases / Q000150:complications*; D012189:Retrospective Studies; D012640:Seizures / Q000503:physiopathology; D014402:Tuberous Sclerosis / Q000150:complications* / Q000601:surgery*