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.
From the Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington.
Accepted for publication October 29, 2013.
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 firstname.lastname@example.org.