![]() ![]() Postoperative complications after inhaled anesthesia have been reported in a narcoleptic patient who had increased sensitivity to general anesthetics. 1 Due to the rarity of the syndrome, guidelines for the anesthetic management and/or monitoring of patients with narcolepsy during surgery have not been established. Narcolepsy or Gélineau syndrome is a chronic sleep disorder of unknown etiology characterized by uncontrollable attacks of deep sleep and is typically associated with cataplexy (sudden complete loss of muscle tone). ![]() BIS monitoring is a simple method that could offer an early warning of an imminent episode, with its associated hazards, in patients with narcolepsy-cataplexy undergoing surgery under regional anesthesia. The purpose of presenting this report is to emphasize the fact that narcoleptic patients can still run the risk of loss of consciousness with atonia under regional anesthesia, and such an undesirable complication cannot be under-estimated. This was followed by a second “continuous low-vigilance” phase of BIS around 75 with low electromyographic activity, ending with a third “nonresponsive vigilance” phase of a full-blown narcolepsy-cataplexy episode of BIS around 45 with complete loss of muscle power. The patient went through three stages: first a prodromal “intermittent low-vigilance” phase interrupted by high electromyographic activity. We recorded both hemispheres, using two synchronized BIS-XP monitors, during a narcolepsy-cataplexy episode in a 57-yr-old male patient undergoing lower limb surgery under femoral nerve block regional anesthesia. We assessed the utility of using BIS for monitoring a possible narcolepsy-cataplexy episode and whether a distinctive BIS profile might offer an early warning of an impending narcoleptic/cataplectic spell. The Bispectral Index (BIS), an electroencephalographic-derived cerebral monitor, used for monitoring the effects of anesthetic/hypnotic drugs was shown to correlate to various conditions that could influence the eletroencephalogram. Other names for this disorder include excessive daytime sleepiness ( EDS), sleeping disease, paroxysmal sleep, and Gelineau syndrome.Narcolepsy or Gélineau syndrome is an extremely incapacitating chronic sleep disorder of unknown etiology that is characterized by uncontrollable attacks of deep sleep and is typically associated with cataplexy sudden loss of muscle tone. Food and Drug Administration ( FDA) in 1998 approved Provigil ( modafinil), a non- amphetamine drug for treating the excessive sleepiness of narcolepsy. Narcolepsy is usually treated with a medication to improve alertness and an anti-depressant that helps control cataplexy. ![]() ![]() For example, a narcoleptic may fall asleep while driving. It is not a fatal disorder in itself but it can lead to fatalities. Still other persons with narcolepsy may experience severe sleepiness or have severe cataplexy (with one or more episodes of cataplexy per day). Other persons may have moderate sleepiness or infrequent cataplexy (less than one episode a day). Some persons with it have mild sleepiness or rare cataplexy (less than one episode per week). Symptoms most commonly appear in a person's teens and early twenties. It strikes males and females and all races. The disorder is often associated with cataplexy (a sudden loss of muscle tone and paralysis of voluntary muscles associated with a strong emotion), sleep paralysis (immobility of the body that occurs in the transition from sleep to wakefulness), what are called hypnagogic hallucinations (pre-sleep dreams) and automatic behaviors (such as doing something "automatically" and not remembering afterwards how one did it).ġ25,000 Americans are estimated to have narcolepsy. Hypnolepsy: A neurological disorder marked by a sudden recurrent uncontrollable compulsion to sleep. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |