Anesthetic management of a patient with West syndrome
Yamaguchi, S.; Mishio, M.; Okuda, Y.; Kitajima, T.
Masui. Japanese Journal of Anesthesiology 49(1): 69-71
2000
ISSN/ISBN: 0021-4892 PMID: 10689849 Document Number: 522471
A 21-year-old female with West syndrome was scheduled for resection of hordeolum. She had an episode of convulsion at three months of age, and was diagnosed as having West syndrome at one year of age. She had had epileptic seizures twice a week in spite of administration of phenytoin, clonazepam and sodium valproate. These drugs had been administered till the morning of the surgery. After premedication with atropine 0.25 mg, anesthesia was induced with propofol (12 fwdarw 10 fwdarw 8 mg cntdot kg-1 cntdot h-1). The tracheal intubation was performed with vecuronium 0.1 mg cntdot kg-1 and anesthesia was maintained with continuous infusion of propofol 6apprx8 mg cntdot kg-1 cntdot h-1 and local infiltration with 1.0% lidocaine 5ml. We administered phenytoin to prevent epileptic seizures during the surgery. No epileptic seizures occurred perioperatively. We conclude that propofol may be useful for a patient with West syndrome, and we should be careful not to lower the threshold for convulsion during the perioperative period.