ABSTRACT
Hyperkalaemic periodic paralysis is the rarer of the two forms of potassium-associated familial paralysis. We report a family with hyperkalaemic periodic paralysis with paramyotonia and the anaesthetic management of four affected members. In three of these, paralytic episodes had been precipitated by previous anaesthesia, but this was avoided in the anaesthetics described. We conclude from our experiences that with depletion of potassium before surgery, prevention of carbohydrate depletion, avoidance of potassium-releasing anaesthetic drugs and maintenance of normothermia, patients with hyperkalaemic periodic paralysis can be anaesthetised without complications. We have no evidence that they exhibit abnormal sensitivity to nondepolarising neuromuscular relaxants.
Subject(s)
Anesthesia, General , Hyperkalemia/complications , Paralyses, Familial Periodic/complications , Adult , Cholecystectomy , Female , Humans , Male , Myotonia/complications , Paralyses, Familial Periodic/genetics , PedigreeABSTRACT
Central nervous system (CNS) relapse with meningeal leukaemia occurred 6 months after allogeneic bone marrow transplantation (BMT) for acute myeloid leukaemia, without systemic relapse. Despite intrathecal chemotherapy a severe progressive proprioceptive impairment of the lower limbs developed. Autopsy revealed selective ascending tract degeneration of the gracile fasciculi of the posterior columns of the spinal cord and residual endoneurial deposits were found in lumbosacral dorsal nerve roots and ganglia. While CNS relapse may occur in acute leukaemia after chemotherapy, it has rarely been reported following BMT.
