Anaesthesia for caesarean section in a patient with dopa-responsive dystonia or Segawa's syndrome.
Dopa-responsive dystonia, also known as hereditary progressive dystonia with diurnal fluctuation or Segawa's syndrome, is a rare hereditary progressive dystonia with two striking clinical features: a marked diurnal fluctuation of symptoms with symptoms worsening throughout the day and improving after sleep, and a dramatic response to levodopa therapy. Whilst rare, it is treatable, with function being normal or near normal after levodopa therapy. We present our experience of providing anaesthesia for caesarean section in a patient with dopa-responsive dystonia and discuss the safety of levodopa therapy during pregnancy and the anaesthetic management of these patients.
Sinha
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Department of Anaesthetics, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
Hartsilver
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EL
D000328:Adult; D000767:Anesthesia, Epidural / Q000379:methods*; D000773:Anesthesia, Obstetrical / Q000379:methods*; D000775:Anesthesia, Spinal / Q000379:methods*; D000978:Antiparkinson Agents / Q000627:therapeutic use*; D002585:Cesarean Section; D004421:Dystonia / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D013577:Syndrome; D016896:Treatment Outcome
D000978:Antiparkinson Agents; D007980:Levodopa