Advertisement

The Patient With Muscular Dystrophy

  • Seth Landa

Abstract

A 13-year-old boy was scheduled for Harrington rod insertion to correct severe scoliosis. He had been diagnosed as having Duchenne muscular dystrophy at age 5 and had been confined to a wheelchair since age 10.

Physical examination showed an obese young male patient sitting in a wheelchair with a pronounced list to the left. Weight was l90lb; height, 5’4” ; blood pressure, 100/60mmHg; pulse, 106/min; respiration, 22/min; temperature, 37.2°C. Examination of the chest and heart was unremarkable. There was marked weakness of all muscle groups except the hand, forearm, and gastrocnemius muscles.

Keywords

Muscular Dystrophy Duchenne Muscular Dystrophy Duchenne Muscular Dystrophy Malignant Hyperthermia Mitral Valve Prolapse 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Duncan P.: Neuromuscular diseases, in Katz J., Steward P. (eds): Anesthesia and Uncommon Pediatric Diseases. Philadelphia: WB Saunders, 1987, pp 516–8.Google Scholar
  2. 2.
    Duchenne G.B.A.: De 1’electrisation localisée et son application à la pathologie et à la thérapeutique, 2nd éd. Paris: Baillière et fils, 1861.Google Scholar
  3. 3.
    Duchenne G.B.A.: Recherches sur la paralysie musculaire pseudohyper-trophique ou paralysie myosclérotique. Arch Gen Med 1868, 11: 5–25,179-; 209, 305-21, 421-3, 552-88.Google Scholar
  4. 4.
    Zundel W.S., Tyler F.H.: Muscular dystrophies. N Engl J Med 1965, 273: 537, 596.PubMedCrossRefGoogle Scholar
  5. 5.
    Miller J., Lee C: Muscle diseases, in Katz J., Benumof J., Kadis L.B. (eds): Anesthesia and Uncommon Diseases. Philadelphia: WB Saunders, 1981, pp 530–7.Google Scholar
  6. 6.
    Hancock W.: Palpitations and abnormal ECG in muscular dystrophy. Hosp Pract 1989, 24: 21, 24.Google Scholar
  7. 7.
    Zatuchni J. et al: The heart in progressive muscular dystrophy. Circulation 1951, 3: 846–53.PubMedGoogle Scholar
  8. 8.
    Fertoff B.W., Rao J.S.: Muscular dystrophy, dystrophies, in Adelman G. (ed): Encyclopedia of Neuroscience, vol 2. Boston:Birkhauser, 1988, pp 723–4Google Scholar
  9. 9.
    Rowland L.P., Layzer R.B.: X-linked muscular dystrophies, in Vinken PJ, Bruyn G.W. (eds): Handbook of Neurology. Amsterdam: North Holland, 1979, 40: 349–402.Google Scholar
  10. 10.
    Roses A.D., Pericak-Vance M.A., Yamaoka L.H., Stubblefield E., Stajiach J., Vance J.M., Roses M.J., Carter D.B.: Recombinant DNA strategies in genetic neurological diseases. Muscle Nerve 1983, 6: 339–55.PubMedCrossRefGoogle Scholar
  11. 11.
    Hayden M.R., Nichols J.L.: Molecular genetic approaches to the study of the nervous system. Dev Neurosci 1983, 6: 189–214.PubMedCrossRefGoogle Scholar
  12. 12.
    Merritt H.H., Rowland L.P.: Muscle, in Merritt H.H. (ed): A Textbook of Neurology, 6th ed. Philadelphia: Lea & Febiger, 1979, 576–96.Google Scholar
  13. 13.
    Baldwin B.J., Talley R.C., Johnson C., Nutter D.O.: Permanent paralysis of the atrium in a patient with facioscapulohumeral muscular dystrophy. Am J Cardiol 1973, 31: 649–53.PubMedCrossRefGoogle Scholar
  14. 14.
    Aldridge L.M.: Anaesthetic problems in myotonic dystrophy. Br J Anaesth 1985, 57: 1119–30.PubMedCrossRefGoogle Scholar
  15. 15.
    Stoelting R., Dierdorf S., McCammon R.: Anesthesia and Co-existing Disease. New York: Churchill Livingstone, 1988, pp 623–5.Google Scholar
  16. 16.
    Dierdorf S.: Rare co-existing diseases, in Barash P., Stoelting R., Cullen B. (eds): Clinical Anesthesia. Philadelphia: JB Lippincott, 1989, p 440.Google Scholar
  17. 17.
    Bradley W., Rebeiz J.: Progressive muscular dystrophy and chronic myopathies, in Petersdorf R. et al (eds): Harrisons Principles of Internal Medicine. New York: McGraw-Hill 1983, pp 2188–90.Google Scholar
  18. 18.
    Kilburn K.H. et al: Cardiopulmonary insufficiency in myotonic and progressive muscular dystrophy. N Engl J Med 1959, 261: 1089–96.PubMedCrossRefGoogle Scholar
  19. 19.
    Meyers M.B., Garash P.G.: Case history number 90: Cardiac decompensation during enflurane anesthesia. A patient with myotonia atrophica. Anesth Analg 1976, 55: 433–6.PubMedGoogle Scholar
  20. 20.
    Fowler W.M., Pearson CM., Egstrom G.H., et al: Ineffective treatment of muscular dystrophy with an anabolic steroid and other measures. N Engl J Med 1965, 272: 875–872.CrossRefGoogle Scholar
  21. 21.
    Sethna N. et al: Anesthesia-related complications in children with Duchenne muscular dystrophy. Anesthesiology 1988, 68: 462–5.PubMedCrossRefGoogle Scholar
  22. 22.
    Marks A.R., Choong C.Y., Sanfillipo A.J., et al: Identification of high-risk and low-risk subgroups of patients with mitral valve prolapse. N Engl J Med 1989, 320: 1031–6.PubMedCrossRefGoogle Scholar
  23. 23.
    Milne B., Rosales J.K.: Anesthetic considerations in patients with muscular dystrophy undergoing spinal fusion and Harrington rod insertion. Can Anaesth Soc J 1982, 29: 250–4.PubMedCrossRefGoogle Scholar
  24. 24.
    Tsueda K., Shibutani K., Lefkowitz M.: Postoperative ventilatory failure in an obese myopathic woman with periodic somnolence. A case report. Anesth Analg 1975, 54: 523–6.PubMedGoogle Scholar
  25. 25.
    Smith C.L., Bush G.H.: Anaesthesia and progressive muscular dystrophy. Br J Anaesth 1985, 57: 1113–18.PubMedCrossRefGoogle Scholar
  26. 26.
    Ishizawa Y., Yamaguchi H., Dohi S., et al: A serious complication due to gastrointestinal malfunction in a patient with myotonic dystrophy. Anesth Analg 1986, 65: 1066–8.PubMedCrossRefGoogle Scholar
  27. 27.
    Cobham J.G., Davis H.S.: Anesthesia for muscular dystrophy patients. Anesth Analg 1964, 43: 22–32.PubMedCrossRefGoogle Scholar
  28. 28.
    Wislicki L.: Anaesthesia and post-operative complications in progressive muscular dystrophy. Anaesthesia 1962, 17: 482–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Henderson W.A.V.: Succinylcholine-induced cardiac arrest in unsuspected Duchenne muscular dystrophy. Can Anaesth Soc J 1984, 31: 444–6.PubMedCrossRefGoogle Scholar
  30. 30.
    Kelfer H.M., Singer W.D., Reynolds R.N.: Malignant hyperthermia in a child with Duchenne muscular dystrophy. Pediatrics 1983, 71: 118–9.PubMedGoogle Scholar
  31. 31.
    Mitchell M.M., Ali H.H., Savarese J.J.: Myotonia and neuromuscular blocking agents. Anesthesiology 1978, 49: 44–8.PubMedCrossRefGoogle Scholar
  32. 32.
    Zalman F., Perloff J.K., Durant N.N., et al: Acute respiratory failure following intravenous verapamil in Duchenne’s muscular dystrophy. Amer Heart J 1983, 105: 510–11.PubMedCrossRefGoogle Scholar
  33. 33.
    Emerg A.E.H., Skinner R.: Double blind controlled trial of a “calcium blocker” in Duchenne muscular dystrophy. Cardiomyology 1983, 2: 13–23.Google Scholar
  34. 34.
    Dressner D.L., Ali H.H.: Anaesthetic management of a patient with facioscapulohumeral muscular dystrophy. Br J Anaesth 1989, 62: 331–4.CrossRefGoogle Scholar
  35. 35.
    Jacob J.G., Varkey G.P.: Curare sensitivity in ocular myopathy. Can Anaesth Soc J 1966, 13: 449–52.PubMedCrossRefGoogle Scholar

Copyright information

© Birkhäuser Boston 1991

Authors and Affiliations

  • Seth Landa

There are no affiliations available

Personalised recommendations