title: Multiple sclerosis: basic knowledge and new insights in perioperative management.
abstract: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system affecting young adults that may lead to significant disability. The clinical course varies among the types of the disease as well as among individuals. Herein we provide a brief review of the recent data concerning the clinical presentation, diagnosis, causes, and pathogenesis of MS as well as medication used, followed by the anesthetic considerations of patients diagnosed with the disease. To accomplish this, we conducted a systematic PubMed literature search for articles, using the terms multiple sclerosis, anesthesia, general, regional, perioperative, and preoperative, and we then manually reviewed the references from each pertinent article. Because randomized controlled trials on the field are rare, most information is derived by case reports and case series. We concluded that the disease itself as well as the treatment modalities may have several implications in the conduct of anesthesia and perioperative management of MS patients. General and regional anesthetic techniques have been successfully used. With thorough preoperative evaluation and in depth knowledge of the disease and its complications, the MS patients can be managed safely.
authors: Department of Anesthesiology, Asklepieion Hospital of Voula, Vas. Pavlou 1, Voula, 16673, Athens, Greece, makrisalexandros@hotmail.com.
authors: Alexandros
authors: A
authors: Makris
authors: Alexandros
authors: A
authors: Piperopoulos
authors: Iosifina
authors: I
authors: Karmaniolou
mesh_terms: D000765:Anesthesia, Conduction / Q000379:methods*; D000768:Anesthesia, General / Q000379:methods*; D006801:Humans; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000473:pathology / Q000601:surgery* / Q000628:therapy; D019990:Perioperative Care / Q000379:methods; D059035:Perioperative Period / Q000379:methods
references: Can J Anaesth. 2005 May;52(5):454-8
references: 15872120
references: Mult Scler. 2010 Jul;16(7):773-85
references: 20483884
references: J Neurol Sci. 1999 Jan 15;162(2):162-8
references: 10202981
references: Neuroimage. 2012 Feb 15;59(4):3110-8
references: 22138253
references: J Clin Anesth. 1988;1(1):21-4
references: 3272740
references: Ann Fr Anesth Reanim. 1988;7(1):68-70
references: 3348516
references: J Neurol Sci. 1987 Jun;79(1-2):83-90
references: 3302114
references: Int Anesthesiol Clin. 2011 Fall;49(4):144-65
references: 21956084
references: Muscle Nerve. 1995 Oct;18(10):1216-7
references: 7659122
references: Acta Anaesthesiol Scand. 2007 Aug;51(7):831-8
references: 17488315
references: Neurology. 1992 Nov;42(11):2088-93
references: 1331868
references: Rev Esp Anestesiol Reanim. 2006 Dec;53(10):673-4
references: 17302088
references: Can J Anaesth. 2013 May;60(5):479-83
references: 23456228
references: Int J Obstet Anesth. 2006 Apr;15(2):115-23
references: 16488136
references: Curr Opin Anaesthesiol. 2002 Jun;15(3):365-70
references: 17019227
references: Eur Rev Med Pharmacol Sci. 2011 Apr;15(4):458-60
references: 21608443
references: Anesth Analg. 1999 May;88(5):1083-4
references: 10320174
references: ISRN Neurol. 2012;2012:427102
references: 23097716
references: Biochim Biophys Acta. 2011 Feb;1812(2):252-64
references: 20619340
references: Anesthesiology. 1987 Mar;66(3):400-2
references: 3826700
references: Clin Neurophysiol. 2007 Aug;118(8):1753-8
references: 17573238