Case Report

Case report: Perioperative management of a patient with familial dysautonomia

Melodie Sarebanha, Laura Valente, Minnea Kalra, A Joseph Layon and Ettore Crimi*

Published: 08 September, 2021 | Volume 6 - Issue 1 | Pages: 029-032

Familial dysautonomia is a rare autosomal recessive neurodegenerative disease affecting cells of the autonomic nervous system. Patients with this disease are insensitive to pain but their autonomic nervous system is still activated with noxious stimuli. This report details a case of a patient with familial dysautonomia who underwent right ankle open reduction and internal fixation for a bimalleolar right ankle fracture. The patients preoperative and intraoperative course were uneventful but shortly after handoff to the intensive care unit, the patient experienced an autonomic crisis. Management of these patients is complex, requiring maintenance of physiologic homeostasis as well as preventing hemodynamic instability caused by noxious stimuli. Any deviations from baseline may cause an autonomic crisis, as happened in our patient. Herein, we detail the perioperative management of a patient with familial dysautonomia in further detail.

Read Full Article HTML DOI: 10.29328/journal.jcicm.1001038 Cite this Article Read Full Article PDF


IKAP: IκB Kinase complex–Associated Protein; ELP1: Elongator Complex Protein 1; ICU: Intensive Care Unit


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