CASE REPORTS   

Journal of Neurosurgical Sciences 2004 September;48(3):135-7

Copyright © 2005 EDIZIONI MINERVA MEDICA

language: English

Prophylaxis to avert exacerbation/relapse of multiple sclerosis in affected patients undergoing surgery. Surgical observations and recommendations

Dickerman R. D. ¹, Schneider S. J. ², Stevens Q. E. ², Matarese N. M. ², Decker R. E. ²

¹ Department of Neurosurgery Plano Presbyterian Hospital and Texas Back Institute Plano, TX, USA 2 Departtment of Neurosurgery North Shore University Hospital Long-Island Jewish Health System New Hyde Park, NY, USA

To pro­vide the neu­ro­log­i­cal and neu­ro­sur­gi­cal com­mu­nities ­with ­case evi­dence of post­op­er­a­tive mul­ti­ple scler­o­sis (MS) ­relapse, lit­er­a­ture ­review to sup­port oper­a­tive ­stress-­induced ­relapse and rec­om­men­da­tions for per­i­op­er­a­tive pro­phy­lax­is to pre­vent ­relapse in ­patients under­go­ing sur­gery. Two ­case stud­ies are pre­sent­ed ­with rec­om­men­da­tions ­based on an exten­sive ­review of the med­i­cal lit­er­a­ture and per­son­al expe­ri­ence to sup­port per­i­op­er­a­tive pro­phy­lac­tic sug­ges­tions. Both ­patients ful­ly recov­ered to pre­op­er­a­tive func­tion­al stat­us ­after treat­ment. We now rou­tine­ly imple­ment per­i­op­er­a­tive pro­phy­lax­is to MS ­patients under­go­ing sur­gery at our insti­tu­tion ­with no com­pli­ca­tions to ­date. Perioperative pro­phy­lax­is in ­patients ­with MS under­go­ing sur­gery can pre­vent ­relapse. It is of ­utmost impor­tance ­that the sur­gi­cal com­mu­nity realiz­es ­that pro­phy­lac­tic treat­ment is avail­able and ­should be uti­lized dur­ing elec­tive and emer­gent sur­gi­cal sit­u­a­tions.