Canadian Journal of Anesthesia

, Volume 46, Issue 7, pp 679–682 | Cite as

Strümpell’s disease in a patient presenting for Cesarean section

Clinical Report



The anesthetic management of a parturient with Strümpell’s disease (hereditary or familial spastic paraparesis) who presented for Cesarean section is described. This neurological disorder is briefly reviewed and anesthetic implications of the condition are discussed.

Clinical Features

A 30-yr-old woman in premature labour presented for Cesarean section. She had bilateral lower limb spastic paresis which had resulted in her being confined to a wheelchair from the age of 13 yr. A diagnosis of Strümpell’s disease had been made in childhood, She was currently receiving thromboprophylaxis, having suffered a deep venous thrombosis four weeks after a previous Cesarean section. The patient was in mild respiratory distress. Despite a history of uneventful general anesthesia and the aforementioned complicating factors, epidural anesthesia was considered the most appropriate technique in these circumstances. An epidural catheter was sited at the L3L4 interspace. Adequate anesthesia for the procedure was obtained after administration of 20 ml lidocaine 2% with 100 μg epinephrineand 100 μg fentanyl in saline. Postoperatively and at six month follow-up there were no neurological complications related to the use of epidural anesthesia.


Strümpell’s disease is an inherited progressive spastic paresis predominantly affecting the lower extremities. Epidural anesthesia appears to be an appropriate technique when administering anesthesia for Cesarean section under similar circumstances.


Amyotrophic Lateral Sclerosis Enoxaparin Spinal Anesthesia Succinylcholine Regional Anesthesia 



Décrire la gestion de l’anesthésie d’une parturiente atteinte de paralysie spinale spasmodique (paraparésie spastique familiale ou héréditaire) admise pour une césarienne. Revoir brièvement ce désordre neurologique et discuter des implications anesthésiques liées à cet état.

’Eléments cliniques

Une femme de 30 ans, en travail prématuré, s’est présentée pour subir une césarienne. Elle avait une parésie bilatérale des membres inférieurs qui l’avait confinée à un fauteuil roulant depuis l’âge de 13 ans. Pendant son enfance, un diagnostic de paralysie spinale spasmodique avait été fait. Au moment de son admission, elle recevait une thromboprophylaxie, car elle avait souffert d’une thrombose veineuse profonde quatre semaines après une précédente césarienne. La patiente présentait une légère détresse respiratoire. Malgré une anesthésie générale déjà administrée avec succès et les facteurs de complications susmentionnés, l’anesthésie péridurale a été considérée comme la technique la plus appropriée dans les circonstances. Un cathéter épidural a été placé dans l’espace entre L3 L4. Une anesthésie adéquate a été obtenue à la suite de l’administration de 20 ml de lidocaïne 2 % et de 100 μg d’épinéphrine et de 100 μg de fentanyl dans une solution salée. Après l’opération et lors d’une visite de contrôle six mois plus tard, il n’y avait pas de complications neurologiques liées à l’usage de l’anesthésie péridurale.


La paralysie spinale spasmodique est une parésie héréditaire spastique et progressive affectant surtout les extrémités inférieures. Lanesthésie péridurale est apparue comme une technique appropriée à la césarienne dans des circonstances semblables.


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Copyright information

© Canadian Anesthesiologists 1999

Authors and Affiliations

  1. 1.Department of Anesthcsiology and Intensive CareHaugesund General HospitalHaugesundNorway

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