Difficult intubation of a patient with progressive multifocal leukoencephalopathy and muscle spasticity: A case report.
10.17085/apm.2018.13.2.149
- Author:
Ji Eun KIM
1
;
Young Kwon YANG
;
Mi Young KWON
;
Mi Jung YUN
;
Gunn Hee KIM
Author Information
1. Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea. kimje78@gmail.com
- Publication Type:Case Report
- Keywords:
Intubation;
Muscle spasticity;
Progressive multifocal leukoencephalopathy
- MeSH:
Airway Management;
Anesthesia, General;
Central Nervous System;
Classification;
Cognition Disorders;
Humans;
Intubation*;
Leukoencephalopathy, Progressive Multifocal*;
Middle Aged;
Mouth;
Muscle Spasticity*;
Paresis;
Patient Compliance
- From:Anesthesia and Pain Medicine
2018;13(2):149-153
- CountryRepublic of Korea
- Language:English
-
Abstract:
Progressive multifocal leukoencephalopathy (PML) is a demyelinating central nervous system disease characterized by neurological deficits, including cognitive impairment, altered mental status, and muscle spasticity. Preoperative evaluation and intraoperative airway management of the airway is difficult in patients with this disease. In this report, the authors describe a 62-year-old man with PML and spastic hemiparesis, who was scheduled for video-assisted thoracic bullectomy under general anesthesia. A preoperative airway evaluation, including Mallampati classification, could not be performed due to lack of patient cooperation. Additionally, the anesthesiologist did not perform diverse physical assessments of the airway or prepare an adequate airway management strategy. During induction of general anesthesia, difficulty with intubation was encountered because of limited mouth opening. This case emphasizes that anesthesiologists should have thorough knowledge of airway assessment and management strategies, and perform a comprehensive assessment to implement appropriate airway management in patients with this disease.
