Correspondence| Volume 53, 103616, February 2023

Labour epidural in a patient with neurofibromatosis type 1 or von Recklinghausen’s disease: a shift in recommendations?

Published:December 05, 2022DOI:
      We wish to highlight the dilemmas and lack of consensus around the anaesthetic management of patients with neurofibromatosis type 1 presenting for emergency obstetric surgery. A 29-year-old primigravid woman in labour was referred to the anaesthesiologist for labour epidural analgesia. She gave a history of neurofibromatosis type 1 diagnosed in childhood and was last followed up four years previously when magnetic resonance imaging (MRI) of the brain and spine showed no significant findings. On anaesthetic review she was asymptomatic except for the presence of café au lait spots and cutaneous neurofibromas. There was no history of back pain, headache, neurological deficits or hypertension. She had multiple cutaneous neurofibromas on her trunk, including the lower back. Neurological examination was normal, with no sensory or motor deficits. She had normal curvature of the spine and airway examination was not suggestive of difficult intubation.


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