title: Neurologic disease with pregnancy and considerations for the obstetric anesthesiologist.
abstract: Women with neurologic conditions present a challenge during pregnancy and in the peripartum period. Given the low prevalence of these diseases during pregnancy, most management decisions are guided by retrospective reviews and case reports. This article reviews current literature for some of the more common or complex neurologic conditions affecting pregnancy with special consideration for anesthetic management. In particular, epilepsy; multiple sclerosis; primary intracranial hypertension; secondary intracranial hypertension-Arnold-Chiari malformations and intracranial neoplasms; spinal cord injury; neuromuscular junction disorders-myasthenia gravis; and hereditary neuromuscular disorders-myotonic dystrophy and spinal muscular atrophy will be discussed. By increasing understanding of anesthetic issues for parturients with neurologic disease, providers may more effectively anticipate anesthetic considerations, thereby optimizing care plans.
authors.affiliation: Department of Anesthesiology & Critical Care Medicine, The George Washington University School of Medicine & Health Sciences, Washington, DC.
authors.forename: Amanda N
authors.initials: AN
authors.lastname: Hopkins
authors.affiliation: Wayne State University School of Medicine, Detroit, MI.
authors.forename: Taghreed
authors.initials: T
authors.lastname: Alshaeri
authors.affiliation: Department of Anesthesiology & Critical Care Medicine, The George Washington University School of Medicine & Health Sciences, Washington, DC.
authors.forename: Seth A
authors.initials: SA
authors.lastname: Akst
authors.affiliation: Department of Anesthesiology & Critical Care Medicine, The George Washington University School of Medicine & Health Sciences, Washington, DC. Electronic address: jberger@mfa.gwu.edu.
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Berger
mesh_terms: D000773:Anesthesia, Obstetrical / Q000379:methods* / Q000592:standards; D005260:Female; D006801:Humans; D009422:Nervous System Diseases / Q000150:complications* / Q000188:drug therapy; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*
keywords: Arnold-chiari malformations; Epilepsy; Multiple sclerosis; Myasthenia gravis; Myotonic dystrophy; Neoplasm; Obstetric anesthesia; Pregnancy; Primary intercranial hypertension; Seizure disorder; Spinal cord injury; Spinal muscular atrophy; disease