Anesthetic Management of a Patient With Spasmodic Torticollis Treated With a Deep Brain Stimulator Implant Operated for Inguinal Hernia

Abstract

Spasmodic torticollis (ST) is the most frequent and familiar type of focal dystonia. Nowadays, deep brain stimulation (DBS) seems to be an effective treatment for ST and is considered a first-line therapy. Anesthesia in such patients requires special considerations, because of the characteristics of the disease as well as the respective treatment. We present the anesthetic management of a patient with ST treated with DBS. A 53-year-old man with idiopathic cervical dystonia treated with a deep brain stimulator device underwent an inguinal hernia correction under general anesthesia. A detailed preanesthesia evaluation was performed to assess any issues associated with the disease especially concerning the airway. A total intravenous anesthesia technique was planned. The device was turned off immediately after induction and turned on before emergency. The patient did not report any discomfort and the stimulator did not present any malfunction or interference with other devices. Anesthetic management of patients with ST treated with deep brain stimulator should focus on a careful preanesthesia evaluation regarding primarily the airway examination, a detailed planning of the anesthetic technique to be applied, and a correct handling of the DBS implanted as it can interfere with other monitoring and therapeutic devices, sometimes with severe consequences. J Med Cases. 2016;7(9):376-378 doi: http://dx.doi.org/10.14740/jmc2588w