Multiple sclerosis in an acquired, demyelinating disease of the central nervous system. Clinically, it is characterized by episodes of focal disorder of the optic nerves, spinal cord, and brain, which remit to a varying extent and recur over a
period of
many years.
Because of the possibilities of neurologic exacerbation, general anesthesia is usually recommended, while spinal anesthesia is discouraged.
Epidural anesthesia may be less of a risk than spinal anesthesia, because the concentration of local anesthetic in spinal cord white matter is lower.
Other regional anesthesia is not likely to predispose postoperative exacerbation of multiple sclerosis, but a controlled study has not been performed.
A 17 year-old female patient with advanced multiple sclerosis was successfully managed for internal fixation of ulnar fracture using brachial plexus block.
The patient recovered well after block without any aggravation of neurologic symptoms.
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