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Spinal Anesthesia for Cesarean Delivery in a Woman with Neuromyelitis Optica

Greene, Nathaniel MD; Dinges, Emily MD; Ciliberto, Christopher MD; Sedensky, Margaret MD, PhD; Landau, Ruth MD

A&A Case Reports:
doi: 10.1213/XAA.0000000000000016
Case Reports: Case Report

Neuromyelitis optica (NMO), or Devic’s disease, is an idiopathic severe demyelinating disease that preferentially affects the optic nerve and spinal cord. Neuraxial anesthesia in women with multiple sclerosis is widely accepted, but reports of the use of neuraxial anesthesia in patients with NMO are scarce. We report the case of a morbidly obese primigravida undergoing a planned cesarean delivery at 32 weeks’ gestation due to an acute exacerbation of NMO, managed with spinal anesthesia. Other than increased intraoperative hyperalgesia requiring inhaled nitrous oxide/oxygen, the mother experienced no apparent anesthetic-related complications.

Author Information

From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.

Accepted for publication October 29, 2013.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Ruth Landau, MD, Department of Anesthesiology and Pain Medicine, University of Washington, 1959 NE Pacific St., Box 356540, Seattle, WA. Address e-mail to

© 2014 International Anesthesia Research Society

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