title: Spinal anaesthesia in a patient with hereditary spastic paraplegia: case report and literature review.
abstract: We report the use of spinal anaesthesia in a patient with hereditary spastic paraplegia who presented for manual removal of placenta following a normal vaginal delivery. This 18-year-old primigravida had been diagnosed with hereditary spastic paraplegia at 8 years of age when neurological examination revealed mild bilateral lower limb spasticity. A 25-gauge Whitacre spinal anaesthetic needle was inserted at the L3-4 intervertebral space and 0.5% plain bupivacaine 2 mL plus fentanyl 25 microg administered. The procedure was uneventful. At 24 hours postoperatively, there was full neurological recovery to pre-anaesthetic levels. The hereditary spastic paraplegias are a group of neurological disorders characterised by a slowly progressing spastic paraparesis. The neurological disorder and its anaesthetic implications are reviewed.
authors.affiliation: Department of Obstetric Anaesthesia, St Michael's Hospital, Bristol, UK. Thmsia@aol.com
authors.forename: I
authors.initials: I
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Thomas
authors.forename: M
authors.initials: M
authors.lastname: Scrutton
mesh_terms: D000293:Adolescent; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D005113:Extraction, Obstetrical / Q000379:methods; D005260:Female; D006801:Humans; D018457:Placenta, Retained / Q000628:therapy*; D011247:Pregnancy; D015419:Spastic Paraplegia, Hereditary