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.
Keywords
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Article info
Publication history
Published online: December 05, 2022
Accepted:
November 29,
2022
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
