Nemaline myopathy: a chance diagnosis and management dilemma

Nemaline myopathy is one of the most rare muscle disorders and its diagnosis is based on both clinical and histopathological findings in muscle biopsy. Chances of missing the diagnosis are high considering the rarity of the disease. Here, the authors discuss a case of nemaline myopathy which was in fact a chance diagnosis that led to intraoperative changes in the plan of anaesthesia, successfully abetting the complications related to it. Although general anaesthesia has been used in a similar patient population in the past, the authors advocate the use of epidural anaesthesia considering the benefits of the same over the added risks of general anaesthesia.