Regional Anesthesia in the Presence of Neurologic Disease

Performing regional anesthesia in patients with preexisting neurologic or neuromuscular disease remains controversial. Numerous anecdotal reports describe the successful use of regional techniques in a variety of neuromuscular disorders including multiple sclerosis, amyotrophic lateral sclerosis (ALS), muscular dystrophies, myotonias, and others.1 However, a study of significant size to confirm or support the safety of regional anesthesia in these patients continues to remain scarce. Specific guidelines regarding the use of regional techniques in the setting of neurologic disease are difficult to define because of these limitations. Therefore, the goal of this chapter is to review several of the more common neurologic disorders that an anesthesiologist may encounter and outline what information currently exists to help guide the use of regional anesthesia.