Abstract
BackgroundParamyotonia congenita is a rare autosomal dominant myopathy which presents with periodic weakness due to cold and exercise. It is caused by mutations of the SCN4 gene which encodes the sodium channel in skeletal muscles.Case presentationWe report a full term obstetric patient with both paramyotonia congenita and terminal filum lipoma who presents for induction of labour followed by an emergency caesarean section performed under epidural anesthesia. Her recovery is subsequently complicated by a 3-day history of postpartum paraparesis attributed to hypokalemic periodic paralysis.ConclusionWe describe the perioperative anesthesia considerations and challenges in this case with a review of the current literature. This case report highlights the importance of early proactive and collaborative multidisciplinary approach, maintaining normal temperature and electrolytes with a heightened vigilance for muscle-related perioperative complications.
Highlights
Paramyotonia congenita is a rare autosomal dominant myopathy which presents with periodic weakness due to cold and exercise
We describe the perioperative management of a parturient who suffered from prolonged limb weakness, most likely due to hypokalemic periodic paralysis after emergency caesarean section (CS) under epidural anaesthesia
Our literature search of obstetric Paramyotonia congenita (PMC) reveals case reports by Grace et al [4] and more recently Najid et al [5] who described an emergency CS of a parturient with PMC that was done under epidural anaesthesia
Summary
We describe the perioperative anesthesia considerations and challenges in this case with a review of the current literature.
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