Anesthetic considerations in Leigh disease: case report and literature review

Leigh disease is an extremely rare disorder, characterized by a progressive neurodegenerative course, with subacute necrotizing encephalomyelopathy. It usually presents in infancy with developmental delay, seizures, dysarthria, and ataxia. These patients may also develop episodes of lactic acidosis that usually lead to respiratory failure and death. Due to the rarity of the condition, the most appropriate anesthetic plan remains unclear. We present a patient with Leigh disease, who required general anesthesia. The pathogenesis of the disease is discussed and previous reports of perioperative care from the literature are reviewed

Awake craniotomy using initial sleep with laryngeal mask airway in depressed agitated patient. A case report

Depressed patients with brain tumors are often not referred to awake craniotomy because of concern of uncooperation which may increase the risk of perioperative complications. This report describes an interesting case of Awake Craniotomy for frontal lobe glioma in 41 year old woman undergoing language and motor mapping intra-operatively. As she was fearful and apprehensive and was on antidepressant therapy to control depression the author adapted general anesthesia with laryngeal mask airway during initial stage of skull pinning and craniotomy procedures. Then patient reverted to awake state to continue the intended neurosurgical procedure. Patient tolerated the situation satisfactory and was cooperative till the finish without any event