Ultrasound-guided peripheral regional blockade in CMT: a review of 3 cases

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Can J Anaesth. 2008 Aug;55(8):515-20.

Ultrasound-guided peripheral regional blockade in patients with

Charcot-Marie-Tooth disease: a review of three cases:

[bloc regional peripherique echoguide chez les patients souffrant de

la maladie de Charcot-Marie-Tooth: compte-rendu de trois cas].

Dhir S, Balasubramanian S, Ross D.

Assistant Professor, Department of Anesthesia and Perioperative

Medicine, St ph's Health Care, 268 Grosvenor Street, University

of Western Ontario, London, Ontario N6A 4V2, Canada.

PURPOSE: To describe the clinical presentation of three patients with

Charcot-Marie-Tooth disease, who underwent uneventful upper limb

surgery following successful peripheral nerve blockade, and to review

the anesthetic implications in patients with Charcot-Marie-Tooth

disease.

Clinical features: In three patients with Charcot-Marie-Tooth disease

presenting for surgery of the upper limb, the motor response,

following nerve stimulation, was suboptimal. However, ultrasound

guidance was effective in visualizing the needle-nerve interaction,

and local anesthetic was injected around the nerves. Good block

ensued and surgery proceeded in all patients without complications.

No exacerbation of the neurological condition was observed in any

patient.

Conclusions: Charcot-Marie-Tooth disease is a demyelinating,

hereditary, motor and sensory neuropathy characterized by

abnormalities of nerve conduction. Regional anesthesia of the upper

limb is feasible in these patients, and these cases show that

ultrasound guidance makes peripheral nerve block possible in patients

for whom traditional methods of nerve localization fail.