Zusammenfassung
Neuromuskuläre Erkrankungen können in 4 Hauptgruppen unterteilt werden: die Motoneuronerkrankungen, die peripheren Neuropathien, die Transmissionsstörungen und die Myopathien, die die größte Gruppe bilden. Bei den Motoneuronerkrankungen ergeben sich Probleme hauptsächlich aufgrund der respiratorischen Probleme und der Prädisposition zu Aspirationen bedingt durch die fortschreitende Muskelschwäche. Depolarisierende Muskelrelaxanzien können myotone Reaktionen und massive Hyperkaliämien auslösen, gegenüber nicht depolarisierenden Muskelrelaxanzien besteht hingegen eine extreme Überempfindlichkeit. Bei den peripheren Neuropathien stehen kardiale Einschränkungen im Vordergrund, wobei autonome Regulationsstörungen die kardiovaskuläre Instabilität noch verstärken können. Auf negativ inotrope Effekte der Anästhetika muss daher besonders geachtet werden. Bei höhergradigen AV-Blockierungen kann der Einsatz eines Schrittmachers erforderlich sein. Beim Charcot-Marie-Tooth-Syndrom besteht eine erhöhte Sensitivität auf Thiopental. Die Transmissionsstörungen machen sich in erster Linie durch respiratorische Probleme bemerkbar. Die fluktuierende Schwäche der Bulbär- und Atemmuskulatur kann zu Schluckstörungen, rezidivierenden Aspirationen bis hin zu respiratorischen Insuffizienz führen. Aufgrund der reduzierten Anzahl der Acetylcholinrezeptoren kommt es zu einer stark erhöhten Empfindlichkeit gegenüber nicht depolarisierenden Muskelrelaxanzien, z. T. auch zu einem verminderten Ansprechen auf Succinylcholin. Zu beachten ist, dass verschiedene Medikamente (z. B. Antibiotika, β-Blocker u. a.), die die neuromuskuläre Übertragung verschlechtern, bei diesen Patienten zu einer erheblichen Verstärkung der Symptome führen können. Bei den progressiven Muskeldystrophien wird das anästhesiologische Risiko weitgehend durch die häufigen kardialen und pulmonalen Einschränkungen bestimmt. Succinylcholin birgt ein hohes Risiko eines hyperkaliämischen Herzstillstandes. Patienten mit einer metabolischen Myopathie sind besonders durch den Mitbefall des Myokards gefährdet, respiratorische Probleme sind hier seltener. Der Muskelstoffwechsel sollte mit entsprechender Substratgabe (je nach Krankheitsbild) unterstützt werden. Bei den Membranstörungen können Muskelrigidität (myotone Reaktion) oder -schwäche zu respiratorischer Insuffizienz führen. Neben depolarisierenden Relaxanzien können auch Cholinesterase-Inhibitoren und, je nach Krankheitsbild, auch Hypothermie und Erniedrigung oder Erhöhung des Serum-Kaliumspiegels myotone Reaktionen auslösen.
Abstract
The neuromuscular disorders described are divided into four groups: motoneuron diseases, peripheral neuropathies, disturbances of neuromuscular transmission and myopathies. In motoneuron diseases problems mainly result from respiratory insufficiency and the predisposition for aspiration caused by progressive muscular weakness. Depolarising muscle relaxants may elicit myotonic reaction and massive hyperkalemia. In contrast to non-depolarising muscle relaxants there may be an extreme hypersensitivity. In peripheral neuropathies the cardiac function is often limited whereby dysautonomia may enhance cardiovascular instability. The negative inotropic effect of anaesthetic agents must be observed with care and patients with higher degree of AV blocks may need a cardiac pacemaker during general anaesthesia. The Charcot-Marie-Tooth-Syndrom is characterized with a high sensitivity to thiopental. Disturbances of neuromuscular transmission frequently cause respiratory problems The fluctuating weakness of bulbar and respiratory muscles may impair swallowing and can lead to recurrent aspirations. Due to the reduced number of acetylcholine receptors the sensitivity to non-depolarizing muscle relaxants is elevated and the response to succinylcholine is reduced. Drugs reducing neuromuscular transmission such as antibiotics and β-blockers may enhance these symptoms and should be avoided. In progressive muscular dystrophies the anaesthetic risk is mainly dependent on cardiac and respiratory impairment. Administration of succinylcholine leads to the risk of hyperkalmic cardiac arrest. Patients with metabolic myopathies are also at risk due to the involvement of cardiac muscle but respiratory problems are less frequent. Muscle metabolism should be supported by administration of substrates depending on the underlying disorder. In membrane disorders muscle rigidity (myotonic reactions) or weakness may lead to respiratory insufficiency. In addition to the depolarising muscle relaxants also anticholinesterase drugs, hypothermia and dyskalaemia can evoke myotonic reactions.
Schlüsselwörter
Myopathie - Herzversagen - Respiratorische Insuffizienz - Maligne Hyperthermie - Anästhesierisiko
Key words
Myopathy - Cardiac failure - Respiratory insufficiency - Malignant hyperthermia - Anaesthetic risk
Literatur
-
1
Rosenbaum K J, Neigh J L, Strobel G E.
Sensitivity to nondepolarizing muscle relaxants in amyotrophic lateral sclerosis: report of two cases.
Anesthesiology.
1971;
35
638-641
-
2 Albers J W, Wald J J. Neuroanesthesia and neuromuscular diseases. In: Albin MS (ed) Neuroanesthesia. New York; McGraw-Hill 1997: 453-499
-
3
Azar I.
The response of patients with neuromuscular disorders to muscle relaxants: a review.
Anesthesiology.
1984;
61
173-187
-
4
Flacchino F, Gemma M, Bricchi M, Giombini S, Regi B.
Sensitivity to curare in patients with upper and lower motor neurone dysfunction.
Anaesthesia.
1991;
46
980-982
-
5
Beach T P, Stone W A, Hamelberg W.
Circulation collapse following succinylcholine: Report of a patient with diffuse lower motoneuron disease.
Anesth Analg.
1971;
50
431
-
6
Cooperman L H.
Succinylcholine-induced hyperkalemia in neuromuscular disease.
J Am Med Ass.
1970;
213
1867-1871
-
7
Gronert G A, Lambert E H, Theye R A.
The response of denervated skeletal muscle to succinylcholine.
Anesthesiology.
1973;
39
13-22
-
8
Shime N, Hosokawa T, Hori Y, Hashimoto T, Miyazaki M.
(Anesthetic management of a patient with progressive spinal muscular atrophy).
Masui.
1990;
39
918-920
-
9
Mashio H, Ito Y, Yanagita Y, Fujisawa E, Hada K, Goda Y, Kawahigashi H.
(Anesthetic management of a patient with amyotrophic lateral sclerosis).
Masui.
2000;
49
191-194
-
10 Brown D L. Spinal, epidural and caudal anesthesia. In: Miller RD (ed) Anesthesia. 5th Edition. New York; Churchill Livingstone 2000: 1491-1519
-
11
Vandam L D, Dripps R D.
Exacerbation of preexisting neurologic disease after spinal anesthesia.
N Engl J Med.
1956;
255
843-849
-
12
Hara K, Sakura S, Saito Y, Maeda M, Kosaka Y.
Epidural anesthesia and pulmonary function in a patient with amyotrophic lateral sclerosis.
Anesth Analg.
1996;
83
878-879
-
13
Kochi T, Oka T, Mizuguchi T.
Epidural anesthesia for patients with amyotrophic lateral sclerosis.
Anesth Analg.
1989;
68
410-412
-
14
Chen L K, Chang Y, Liu C C, Hou W Y.
Epidural anesthesia combined with propofol sedation for abdominal hysterectomy in a patient with amyotrophic lateral sclerosis - a case report.
Acta Anaesthesiol Sin.
1998;
36
103-106
-
15 Benumof J L. Anesthesia & Uncommon Diseases. 4th Edition. Philadelphia; Saunders 1998
-
16
Gyermek L.
Increased potency of nondepolarizing relaxants after poliomyelitis.
J Clin Pharmacol.
1990;
30
170-173
-
17
Madrid R, Bradley W G, Davis C J.
The peroneal muscular atrophy syndrome. Clinical, genetic, electrophysiological and nerve biopsy studies. Part 2. Observations on pathological changes in sural nerve biopsies.
J Neurol Sci.
1977;
32
91-122
-
18
Felice K J, Poole R M, Blaivas M, Albers J W.
Hereditary neuropathy with liability to pressure palsies masquerading as slowly progressive polyneuropathy.
Eur Neurol.
1994;
34
173-175
-
19 Mortier W. Muskel- und Nervenerkrankungen im Kindesalter. Stuttgart; Thieme 1994
-
20
Hara K, Minami K, Takamoto K, Shiraishi M, Sata T.
The prolonged effect of a muscle relaxant in a patient with chronic inflammatory demyelinating polyradiculoneuropathy.
Anesth Analg.
2000;
90
224-226
-
21
Brooks H, Christian A S, May A E.
Pregnancy, anaesthesia and Guillain Barre syndrome.
Anaesthesia.
2000;
55
894-898
-
22
Fitzal S.
(Anesthesia in neuromuscular diseases).
Anaesthesist.
1992;
41
730-742
-
23
Zochodne D W.
Autonomic involvement in Guillain-Barre syndrome: a review.
Muscle Nerve.
1994;
17
1145-1155
-
24
Feldman J M.
Cardiac arrest after succinylcholine administrationi n a pregnant patient recovered from Guillain-Barre syndrome.
Anesthesiology.
1990;
72
942-944
-
25
McGrady E M.
Management of labour and delivery in a patient with Guillain-Barre syndrome.
Anaesthesia.
1987;
42
899
-
26
Steiner I, Argov Z, Cahan C, Abramsky O.
Guillain-Barre syndrome after epidural anesthesia: direct nerve root damage may trigger disease.
Neurology.
1985;
35
1473-1475
-
27
Plaugher M E.
Emergent exploratory laparotomy for a patient with recent Guillain-Barre recurrence: a case report.
AANA J.
1994;
62
437-440
-
28
Winer J B, Hughes R A.
Identification of patients at risk of arrhythmia in the Guillain-Barre syndrome.
Q J Med.
1988;
68
735-739
-
29
Albers J W, Kelly J J.
Acquired inflammatory demyelinating polyneuropathies: clinical and electrodiagnostic features.
Muscle Nerve.
1989;
12
435-451
-
30
Hochman M S, Kobetz S A, Handwerker J V.
Inappropriate secretion of antidiuretic hormone associated with Guillain-Barre syndrome.
Ann Neurol.
1982;
11
322-323
-
31
Auer-Grumbach M, Wagner K, Fazekas F, Loscher W N, Strasser-Fuchs S, Hartung H P.
Hereditäre motorisch-sensible Neuropathien (Charcot-marie-Tooth Syndrom) und verwandte Neuropathien. Aktuelle Klassifikation und Genotyp-Phänotyp-Korrelation.
Nervenarzt.
1999;
70
1052-1061
-
32
Antognini J F.
Anaesthesia for Charcot-Marie-Tooth disease: a review of 86 cases.
Can J Anaesth.
1992;
39
398-400
-
33
Kotani N, Hirota K, Anzawa N, Takamura K, Sakai T, Matsuki A.
Motor and sensory disability has a strong relationship to induction dose of thiopental in patients with the hypertropic variety of Charcot-Marie-Tooth syndrome.
Anesth Analg.
1996;
82
182-186
-
34
Reah G, Lyons G R, Wilson R C.
Anaesthesia for caesarean section in a patient with Charcot-Marie-Tooth disease.
Anaesthesia.
1998;
53
586-588
-
35
Naguib M, Samarkandi A H.
Response to atracurium and mivacurium in a patient with Charcot-Marie-Tooth disease.
Can J Anaesth.
1998;
45
56-59
-
36
Drachman D B.
Myasthenia gravis.
N Engl J Med.
1994;
330
1797-1810
-
37
Brown T C, Gebert R, Meretoja O A, Shield L K.
Myasthenia gravis in children and its anaesthetic implications.
Anaesth Intensive Care.
1990;
18
466-472
-
38
Foldes F F, McNall P G.
Myasthenia gravis.
Anesthesiology.
1962;
23
837
-
39
Hunter J M.
New neuromuscular blocking drugs.
N Engl J Med.
1995;
332
1691-1699
-
40
Wainwright A P, Brodrick P M.
Suxamethonium in myasthenia gravis.
Anaesthesia.
1987;
42
950-957
-
41
Telford R J, Hollway T E.
The myasthenic syndrome: anaesthesia in a patient treated with 3.4 diaminopyridine.
Br J Anaesth.
1990;
64
363-366
-
42
Wise R P.
A myasthenic syndrome complicating bronchial carcinoma.
Anasthesia.
1962;
17
488-504
-
43 Lohmann-Horn F, Ludwolph A C. Neurologische Therapie. 3. Auflage. München; Urban & Fischer 2001
-
44
Buzello W, Noeldge G, Krieg N, Brobmann G F.
Vecuronium for muscle relaxation in patients with myasthenia gravis.
Anesthesiology.
1986;
64
507-509
-
45
Enoki T, Naito Y, Hirokawa Y, Nomura R, Hatano Y, Mori K.
Marked sensitivity to pancuronium in a patient without clinical manifestations of myasthenia gravis.
Anesth Analg.
1989;
69
840-842
-
46
Rowbottom S J.
Isoflurane for thymectomy in myasthenia gravis.
Anaesth Intensive Care.
1989;
17
444-447
-
47
Kiran U, Choudhury M, Saxena N, Kapoor P.
Sevoflurane as a sole anaesthetic for thymectomy in myasthenia gravis.
Acta Anaesthesiol Scand.
2000;
44
351-353
-
48
Granell Gil M, Garcia Aguado R, Ferrandiz Roca L, Arnau Obrer A, Canto Armengood A, Grau Real F, Palanca Sanfrancisco J M.
(Fastrach laryngeal mask, sevoflurane and remifentanil: an anesthetic alternative for the myasthenic patient).
Rev Esp Anestesiol Reanim.
2001;
48
85-88
-
49
Kawamata M, Miyabe M, Nakae Y, Sonoda H, Fujimura N, Sumita S, Fujita S, Namiki A.
ontinuous thoracic epidural blockade in combination with general anesthesia with nitrous oxide, oxygen, and sevoflurane in two patients with myasthenia gravis).
Masui.
1993;
42
898-901
-
50
Georgiou L, Bousoula M, Spetsaki M.
Combined thoracic epidural and general anaesthesia with laryngeal mask airway for laparoscopic cholecystectomy in a patient with myasthenia gravis.
Anaesthesia.
2000;
55
821-822
-
51
Hubler M, Litz R J, Albrecht D M.
Combination of balanced and regional anaesthesia for minimally invasive surgery in a patient with myasthenia gravis.
Eur J Anaesthesiol.
2000;
17
325-328
-
52
Abel M, Eisenkraft J.
Sensitivity to atracurium in myasthenia gravis patients during true remission.
Anesthesiology.
1990;
73
A892
-
53
Argov Z, Mastaglia F L.
Drug therapy: Disorders of neuromuscular transmission caused by drugs.
N Engl J Med.
1979;
301
409-413
-
54
Flacke W.
Treatment of myasthenia gravis.
N Engl J Med.
1973;
288
27-31
-
55
Chagnac Y, Hadani M, Goldhammer Y.
Myasthenic crisis after intravenous administration of iodinated contrast agent.
Neurology.
1985;
35
1219-1220
-
56
O'Neill J H, Murray N M, Newsom-Davis J.
The Lambert-Eaton myasthenic syndrome. A review of 50 cases.
Brain.
1988;
111
577-596
-
57
Fadic R, Sunada Y, Waclawik A J, Buck S, Lewandoski P J, Campbell K P, Lotz B P.
Brief report: deficiency of a dystrophin-associated glycoprotein (adhalin) in a patient with muscular dystrophy and cardiomyopathy.
N Engl J Med.
1996;
334
362-366
-
58
Buckley A E, Dean J, Mahy I R.
Cardiac involvement in Emery Dreifuss muscular dystrophy: a case series.
Heart.
1999;
82
105-108
-
59
Barresi R, Di Blasi C, Negri T, Brugnoni R, Vitali A, Felisari G, Salandi A, Daniel S, Cornelio F, Morandi L, Mora M.
Disruption of heart sarcoglycan complex and severe cardiomyopathy caused by beta sarcoglycan mutations.
J Med Genet.
2000;
37
102-107
-
60
Finsterer J, Stollberger C.
Cardiac involvement in primary myopathies.
Caridiology.
2000;
94
1-11
-
61
de Visser M, de Voogt W G, la Riviere G V.
The heart in Becker muscular dystrophy, facioscapulohumeral dystrophy, and Bethlem myopathy.
Muscle Nerve.
1992;
15
591-596
-
62
Laforet P, de Toma C, Eymard B, Becane H M, Jeanpierre M, Fardeau M, Duboc D.
Cardiac involvement in genetically confirmed facioscapulohumeral muscular dystrophy.
Neurology.
1998;
51
1454-1456
-
63
Fitzsimons R B.
Racioscapulohumeral muscular dystrophy.
Curr Opin Neurol.
1999;
12
501-511
-
64
Barohn R J, Levine E J, Olson J O, Menddell J R.
Gastric hypomotility in Duchenne's muscular dystrophy.
N Engl J Med.
1988;
319
15-18
-
65
Ishikawa Y, Bach J R, Sama R J, Tamura T, Song J, Marra S W, Minami R.
Cardiovascular considerations in the management of neuromuscular disease.
Semin Neurol.
1995;
15
93-108
-
66
Shapiro F, Sethna N, Colan S, Wohl M E, Specht L.
Spinal fusion in Duchenne muscular dystrophy: a multlidisciplinary approach.
Muscle Nerve.
1992;
15
604-614
-
67 Griggs R C, Mendell J R, Miller R G. Evaluation and Treatment of Myopathies. Philadelphia; Oxford University Press 1995
-
68
Hoogenwaard E M, Bakker E, Ippel P F, Oosterwijk J C, Majoor-Krakauer D F, Leschot N J, Van Essen A J, Brunner H G, van der Wouw P A, Wilde A A, de Visser M.
Signs and symptoms of Duchenne muscular dystrophy and Becker muscular dystrophy among carriers in The Netherlands: a cohort study.
Lancet.
1999;
353
2116-2119
-
69
Funakoshi M, Tsuchiya Y, Arahata K.
Emerin and cardiomyopathy in Emery-Dreifuss muscular dystrophy.
Neuromuscul Disord.
1999;
9
108-114
-
70
Bush A, Dubowitz V.
Fetal rhabdomyolysis complicating general anaesthesia in a child with Becker muscular dystrophy.
Neuromuscul Disord.
1991;
1
201-204
-
71
Breucking E, Reimnitz P, Schara U, Mortier W.
Inzidenz schwerer Narkosezwischenfälle bei Patienten und in Familien mit progressiven Muskeldystrophien vom Typ Duchenne und Becker.
Anaesthesist.
2000;
49
187-195
-
72
Buzello W, Huttarsch H.
Muscle relaxation in patients with Duchenne's muscular dystrophy. Use of vecuronium in two patients.
Br J Anaesth.
1988;
60
228-231
-
73
Diefenbach C, Buzello W.
Muskelrelaxation beim neuromuskulär kranken Patienten.
Anaesthesist.
1994;
43
283-288
-
74
von zur Muhlen F, Klass C, Kreuzer H, Mall G, Giese A, Reimers C D.
Cardiac involvement in paroximal myotonic myopathy.
Heart.
1998;
79
619-621
-
75 Harper P S, Rudel R. Myotonic Disorders. In: Engel AG, Franzini-Armstrong C (ed) Myology. 2nd Edition. New York; McGraw-Hill 1994: 1192-1219
-
76
Lenard H G, Goebel H H, Weigel W.
Smooth muscle involvement in congenital myotonic dystrophy.
Neuropadiatrie.
1977;
8
42-52
-
77
Horowitz M, Maddox A, Maddern G J, Wishart J, Collins P J, Shearman D J.
Gastric and esophageal emptying in dystrophia myotonica. Effect of metoclopramide.
Gastroenterology.
1987;
92
570-577
-
78
Sarnat H B, Silbert S W.
Maturational arrest of fetal muscle in neonatal myotonic dystrophy. A pathologic study of four cases.
Arch Neurol.
1976;
33
466-474
-
79
Bourke T D, Zuck D.
Thiopentone in dystrophica myotonia.
Br J Anaesth.
1997;
29
35
-
80
Aldrige L M.
Anaesthetic problems in myotonic dystrophy. A case report and review of the Aberdeen experience comprising 48 general anaesthetics in a further 16 patients.
Br J Anaesth.
1985;
57
1119-1130
-
81
Speedy H.
Exaggerated physiological responses to propofol in myotonic dystrophy.
Br J Anaesth.
1990;
64
110-112
-
82
Tzabar Y, Marshall R.
Myotonic dystrophy and target-controlled propofol infusions.
Br J Anaesth.
1995;
74
108-109
-
83
Hansotia P, Frens D.
Hypersomnia associated with alveolar hypoventilation in myotonic dystrophy.
Neurology.
1981;
31
1336-1337
-
84
Mitchell M M, Ali H H, Savarese J J.
Myotonia and neuromuscular blocking agents.
Anesthesiology.
1978;
49
44-48
-
85 Breucking E, Mortier W. Anaesthesia in neuromuscular diseases. In: Mortier W, Breucking E (ed) Malignant Hyperthermia. Neuromuscular Disease and Anaesthesia. Stuttgart; Thieme 1990: 61-71
-
86
Buzello W, Krieg N, Schlickewei A.
Hazards of neostigmine in patients with neuromuscular disorders. Report of two cases.
Br J Anaesth.
1982;
54
529-534
-
87
Diefenbach C, Lynch J, Abel M, Buzello W.
Vecuronium for muscle relaxation in patients with dystrophia myotonica.
Anesth Analg.
1993;
76
872-874
-
88
Anderson B J, Brown T C.
congenital myotonic dystrophy in children - a review of ten years' experience.
Anaesth Intensive Care.
1989;
17
320-324
-
89 Harper P S. Myotonic Dystrophy. 2nd Edition. Philadelphia; Saunders 1989
-
90
Motta J, Guilleminault C, Billingham M, Barry W, Mason J.
Cardiac abnormalities in myotonic dystrophy. Electrophysiologic and histopathologic studies.
Am J Med.
1979;
67
467-473
-
91
Melacini P, Fanin M, Duggan D J, Freda M P, Berardinelli A, Danieli G A, Barchitta A, Hoffman E P, Dalla Volta S, Angelini C.
Heart involvement in muscular dystrophies due to sarcoglycan gene mutations.
Muscle Nerve.
1999;
22
473-479
-
92
Griggs R C, Davis R J, Anderson D C, Dove J T.
Cardiac conduction in myotonic dystrophy.
Am J Med.
1975;
59
37-42
-
93
Grigg L E, Chan W, Mond H G, Vohra J K, Downey W F.
Ventricular tachycardia and sudden death in myotonic dystrophy: clinical, electrophysiologic and pathologic features.
J Am Coll Cardiol.
1985;
6
254-256
-
94
Moxley R T, Corbett A J, Minaker K L, Rowe J W.
Whole body insulin resistance in myotonic dystrophy.
Ann Neurol.
1984;
15
157-162
-
95
Ricker K.
Myotonic dystrophy and proximal myotonic myopathy.
J Neurol.
1999;
246
334-338
-
96
Newman B, Meola G, O'Donovan D G, Schapira A H, Kingston H.
Proximal myotonic myopathy (PROMM) presenting as myotonia during pregnancy.
Neuromuscul Disord.
1999;
9
144-149
-
97
Lehmann-Horn F.
Neuromuscular Disorders and Malignant Hyperthermia.
Anesthesia and Resuscitation.
1994;
30
81-86
-
98
Caccamo D V, Keene C Y, Durham J, Peven D.
Fulminant rhabdomyolysis in a patient with dermatomyositis.
Neurology.
1993;
43
844-845
-
99
Hochberg M C, Feldman D, Stevens M B.
Adult onset polymyositis/dermatomyositis: an analysis of clinical and laboratory features and survival in 76 patients with a review of the literature.
Semin Arthritis Rheum.
1986;
15
168-178
-
100 Eisele J H. Connective tissue diseases. In: Katz J, Benumof J, Kadis LB (eds) Anesthesia and uncommon diseases. 3rd Edition. Philadelphia; Saunders 1990: 645-667
-
101
Ganta R, Campbell I T, Mostafa S M.
Anaesthesia and acute dermatomyositis/polymyositis.
Br J Anaesth.
1998;
60
854-858
-
102
Gottdiener J S, Sherber H S, Hawley R J, Engel W K.
Cardiac manifestations in polymyositis.
Am Cardiol.
1978;
41
1141-1149
-
103
Rockelein S, Gebert M, Baar H, Endsberger G.
Neuromuskuläre Blockade mit Atracurium bei Dermatomyositis.
Anaesthesist.
1995;
44
442-444
-
104
Mair P, Mitterschiffthaler G, Hohlbock E.
Neuromuskuläre Blockade mit Vecuronium bei Dermatomyositis.
Anaesthesist.
1989;
38
626-628
-
105
McFarlane H J, Soni N.
Pompe's disease and anaesthesia.
Anaesthesia.
1986;
41
1219-1224
-
106 Jerusalem F, Zierz S. Muskelerkrankungen. Klinik - Therapie - Pathologie. 2. Auflage. Stuttgart; Thieme 1991
-
107 Engel A G. Acid maltase deficiency. In: Engel AG, Franzini-Armstrong C (eds) Myology. 2nd Edition. New York; McGraw-Hill 1994: 1533-1553
-
108
Moufarrej N A, Bertorini T E.
Respiratory insufficiency in adult-type acid maltase deficiency.
South Med J.
1993;
86
560-567
-
109
Kotani N, Hashimoto H, Hirota K, Muraoka M, Matsuki A.
Prolonged respiratory depression after anesthesia for parathyroidectomy in a patient with juvenile type of acid maltase deficiency.
J Clin Anesth.
1996;
8
620
-
110
Samuels T A, Coleman P.
McArdle's disease and caesarean section.
Anaesthesia.
1988;
43
161-162
-
111
Slonim A E, Goans P J.
Myopathy in McArdle's syndrome. Improvement with a high-protein diet.
N Engl J Med.
1985;
312
355-359
-
112
Rajah A, Bell C F.
Atracurium and McArdle's disease.
Anaesthesia.
1986;
41
93
-
113
Tzabar Y, Ross D G.
Vecuronium and McArdle's disease.
Anaesthesia.
1990;
45
697
-
114
Casson H.
Anaesthesia for portocaval bypass in patients with metabolic diseases.
Br J Anaesth.
1975;
47
969-975
-
115
Shenkman Z, Golub Y, Meretyk S, Shir Y, Landau D, Landau E H.
Anaesthetic management of a patient with glycogen storage disease type 1b.
Can J Anaesth.
1996;
43
467-470
-
116
Lucas M, Hinojosa M, Rodriguez A, Garcia-Guasch R.
Anaesthesia in lipid myopathy.
Eur J Anaesthesiol.
2000;
17
461-462
-
117
Kiechl S, Kohlendorfer U, Paetzke I, Sperl W, Reiner J, Willeit J.
Myoglobinurie und Carnitin-Palmitoyl-Transferase-Mangel. Diagnostische Verfahren und Differentialdiagnose.
Wien Klin Wochenschr.
1994;
106
174-177
-
118
Katsuya H, Misumi M, Ohtani Y, Milke T.
Postanesthetic acute renal failure due to carnitine palmitoyl transferase deficiency.
Anesthesiology.
1988;
68
945-948
-
119
Campos Suarez J M.
(Malignant hyperthermia).
Rev Esp Anestesiol Reanim.
1989;
36
232-239
-
120 Zierz S. Carnitine palmitoyltransferase deficiency. In: Engel AG, Franzini-Armstrong C (eds) Myology. 2nd Edition. New York; McGraw-Hill 1994: 1577-1586
-
121
Angelini C, Vergani L, Martinuzzi A.
Clinical and biochemical aspects of carnitine deficiency and insufficiency: transport defects and inborn errors of beta-oxidation.
Crit Rev Clin Lab Sci.
1992;
29
217-242
-
122 Moundras J M, Wattrisse G, Leroy B, Decocq J, Krivosic-Horber R. Ann Fr Anesth Reanim 2000 19: 611-616
-
123
Fishbein W N, Muldoon S M, Deuster P A, Armbrustmacher V W.
Myoadenylate deaminase deficiency and malignant hyperthermia susceptibility: is there a relationship?.
Biochem Med.
1985;
34
344-354
-
124
DiMauro S, Moraes C T.
Mitochondrial encephalomyopathies.
Arch Neurol.
1993;
50
1197-1208
-
125
Barohn R J, Clanton T, Sahenk Z, Mendell J R.
Recurrent respiratory insufficiency and depressed ventilatory drive complicating mitochondrial myopathies.
Neurology.
1990;
40
103-106
-
126
James R H.
Thiopentone and ophthalmoplegia plus.
Anaesthesia.
1985;
40
88
-
127
James R H.
Induction agent sensitivity and ophthalmoplegia plus.
Anaesthesia.
1986;
41
216
-
128
Breucking E, Mortier W, Lampert R, Brandt L.
Anästhesie und Intensivtherapie bei einer Patientin mit mitochondrialer Myopathie.
Anaesthesist.
1993;
42
719-723
-
129
Lauwers M H, Van Lersberghe C, Camu F.
Inhalation anaesthesia and the Kearns-Sayre syndrome.
Anaesthesia.
1994;
49
876-878
-
130
Robertson J A.
Ocular muscular dystrophy. A cause of curare sensitivity.
Anaesthesia.
1984;
39
251-253
-
131 Lehmann-Horn F, Engel A G, Ricker H, Rüdel R. The Periodic Paralyses and Paramyotonia Congenita. In: Engel AG, Franzini-Armstrong C (eds) Myology. 2nd Edition. New york; McGraw-Hill 1994: 1304-1334
-
132 Rüdel R, Lehmann-Horn F, Ricker K. The Nondystrophic Myotonias. In: Engel AG, Franzini-Armstrong C (eds) Myology. 2nd Edition. New York; McGraw-Hill 1994: 1291-1303
-
133
Venables G S, Bates D, Shaw D A.
Hypothyroidism with true myotonia.
N Neurol Neurosurg Psychiatry.
1978;
41
1013-1015
-
134
Egan T J, Klein R.
Hyperkalaemic periodic paralysis.
Paediatrics.
1959;
24
761
-
135
Aarons J J, Moon R E, Camporesi E M.
General anesthesia and hyperkalemic periodic paralysis.
Anesthesiology.
1989;
71
303-304
-
136
Siler J N, Discavage W J.
Anesthetic management of hypokalemic periodic paralysis.
Anesthesiology.
1975;
43
489-490
-
137
Rollman J E, Dickson C M.
Anesthetic management of a patient with hypokalemic familial periodic paralysis for coronary artery bypass surgery.
Anesthesiology.
1985;
63
526-527
-
138
Thomas A, Leopold U, Winkler H.
Maligne Hyperthermie bei Paramyotonia congenita.
Anaesthesiol Reanim.
1988;
13
295-300
Dr. Christoph P. Baur
Universitätsklinik für Anästhesiologie
Universität Ulm
Steinhövelstraße 9
89070 Ulm
eMail: christoph.baur@medizin.uni-ulm.de