Amyotrophic lateral sclerosis
Other names ALS
Anesthetic relevance

Low

Anesthetic management

- No specific anesthetic drugs are best for this disease - Succinylcholine may cause hyperkalemia due to LMN disease - Non-depolarizing NMDs may be prolonged - Bulbar involvement may increase aspiration risk

Specialty

Neurology

Signs and symptoms
Diagnosis

Based upon clinical signs and symptoms

Treatment
Article quality
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Provide a brief summary of this comorbidity here.

Anesthetic implications

Preoperative optimization

Intraoperative management

  • No ideal anesthesia for this condition
  • Take caution with succinylcholine administration as the LMN disease may incite hyperkalemia after administration
  • Non-depolarizing neuromuscular blockers may be prolonged
  • Take caution with regional anesthesia, although it is not contraindicated
  • Neuraxial:[1]
    • Benefits: decreased chance of prolonged intubation secondary to bulbar weakness
    • Risks: Increased risk of worsening neurologic condition postoperatively, risk of sympathectomy resulting in vasodilation and hypotension, high spinal presents risk of bradycardia, worsening hypotension, cardiovascular collapse.
  • General anesthesia: Increased risk of prolonged intubation secondary to bulbar weakness

Postoperative management

Related surgical procedures

Pathophysiology

  • Progressive upper and lower motor neuron degeneration

Signs and symptoms

  • Skeletal muscle weakness
  • Atrophy of thenar eminences

Diagnosis

Treatment

Medication

Surgery

Prognosis

Epidemiology

Affects men between the ages of 40-60

References

  1. Panchamia, Jason K; Gurrieri, Carmelina; Amundson, Adam W (2020-07). "<p>Spinal Anesthesia for Amyotrophic Lateral Sclerosis Patient Undergoing Lower Extremity Orthopedic Surgery: An Overview of the Anesthetic Considerations</p>". International Medical Case Reports Journal. Volume 13: 249–254. doi:10.2147/imcrj.s256716. ISSN 1179-142X. Check date values in: |date= (help)