Risk of Administering Anesthesia in Undiagnosed Myasthenia Gravis
Myasthenia gravis requires special consideration when it comes to neuromuscular blockade reversal. A 71-year-old male presented with a three-month history of intermittent diplopia and uncontrolled left eye movement. He underwent diagnostic cerebral angiography under general anesthesia to rule out vascular compression of cranial nerve three. He was reversed and extubated successfully. One year later, he presented with worsening myasthenia gravis symptoms. Stroke workup and electromyogram were negative. This case calls into question perioperative safety and preoperative screening in patients with symptoms consistent with undiagnosed neuromuscular junction disorders and how to reduce risk in hospitals where Sugammadex is not readily available.
Marolt C, Fowler J, Soto RG. Risk of administering anesthesia in undiagnosed myastenia gravis. Presented at: American Society of Anesthesiologists Annual Meeting; 2023 Oct 16; San Francisco, CA.