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Canadian Journal of Anesthesia 49:81-83 (2002)
© Canadian Anesthesiologists' Society, 2002
Obstetrical and Pediatric Anesthesia

Anesthetic management for a patient with Jansky-Bielschowsky disease

[L'anesthésie d'une patiente atteinte d'idiotie amaurotique de type Bielschowsky]

Yuko Yamada, MD, Katsushi Doi, MD, Shinichi Sakura, MD and Yoji Saito, MD

From the Department of Anesthesiology, Shimane Medical University, Izumo, Japan.

Address correspondence to: Dr. Katsushi Doi, Department of Anesthesiology, Shimane Medical University, 89-1 Enya-cho, Izumo, 693-8501, Japan. Phone: +81-853-20-2295; Fax: +81-853-20-2292; E-mail: kdoi{at}shimane-med.ac.jp

Purpose: To describe the anesthetic management of a patient with Jansky-Bielschowsky disease (JBD), the late infantile form of neuronal ceroid lipofuscinosis, characterized by dementia, severe and drug resistant grand mal, myoclonic seizures, and blindness.

Clinical features: A 14-yr-old girl with JBD was scheduled for resection of a gingival tumour and an infected sinus in the sacral area. Her preanesthetic examination revealed extreme muscle atrophy and dementia. Grand mal, myoclonic seizures, and upper airway obstruction were frequent. Following iv induction with thiamylal, anesthesia was maintained with sevoflurane, N2O and O2. Her trachea was intubated without using muscle relaxants. Muscle relaxants were not used during the operation. Apart from an intractable hypothermia, the intraoperative course was uneventful. The emergence of anesthesia was smooth, except for persisting seizures.

Conclusion: General anesthesia using thiamylal and sevoflurane provided satisfactory conditions during operation in a patient with JBD. Intraoperative hypothermia required particular attention.






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Copyright © 2002 by the Canadian Anesthesiologists' Society.