An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report

Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecys...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Mukherjee, Souvik [verfasserIn] Waindeskar, Vaishali Molli, Kiran Koovakattil, Akhil Kuttan

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2023

Schlagwörter:	Case report Lambert-Eaton myasthenic syndrome Neuromuscular blocking agents Neuromuscular monitoring Spinal anesthesia

Anmerkung:	© The Author(s) 2023

Übergeordnetes Werk:	Enthalten in: Ain-Shams journal of anaesthesiology - [Berlin : Springer Berlin Heidelberg, 2007, 15(2023), 1 vom: 23. März
Übergeordnetes Werk:	volume:15 ; year:2023 ; number:1 ; day:23 ; month:03

Links:	Volltext

DOI / URN:	10.1186/s42077-023-00317-7

Katalog-ID:	SPR049814885

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allfields	10.1186/s42077-023-00317-7 doi (DE-627)SPR049814885 (SPR)s42077-023-00317-7-e DE-627 ger DE-627 rakwb eng Mukherjee, Souvik verfasserin (orcid)0000-0002-8032-2936 aut An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213 Waindeskar, Vaishali aut Molli, Kiran aut Koovakattil, Akhil Kuttan aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 23. März (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:23 month:03 https://dx.doi.org/10.1186/s42077-023-00317-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 23 03
spelling	10.1186/s42077-023-00317-7 doi (DE-627)SPR049814885 (SPR)s42077-023-00317-7-e DE-627 ger DE-627 rakwb eng Mukherjee, Souvik verfasserin (orcid)0000-0002-8032-2936 aut An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213 Waindeskar, Vaishali aut Molli, Kiran aut Koovakattil, Akhil Kuttan aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 23. März (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:23 month:03 https://dx.doi.org/10.1186/s42077-023-00317-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 23 03
allfields_unstemmed	10.1186/s42077-023-00317-7 doi (DE-627)SPR049814885 (SPR)s42077-023-00317-7-e DE-627 ger DE-627 rakwb eng Mukherjee, Souvik verfasserin (orcid)0000-0002-8032-2936 aut An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213 Waindeskar, Vaishali aut Molli, Kiran aut Koovakattil, Akhil Kuttan aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 23. März (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:23 month:03 https://dx.doi.org/10.1186/s42077-023-00317-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 23 03
allfieldsGer	10.1186/s42077-023-00317-7 doi (DE-627)SPR049814885 (SPR)s42077-023-00317-7-e DE-627 ger DE-627 rakwb eng Mukherjee, Souvik verfasserin (orcid)0000-0002-8032-2936 aut An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213 Waindeskar, Vaishali aut Molli, Kiran aut Koovakattil, Akhil Kuttan aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 23. März (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:23 month:03 https://dx.doi.org/10.1186/s42077-023-00317-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 23 03
allfieldsSound	10.1186/s42077-023-00317-7 doi (DE-627)SPR049814885 (SPR)s42077-023-00317-7-e DE-627 ger DE-627 rakwb eng Mukherjee, Souvik verfasserin (orcid)0000-0002-8032-2936 aut An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report 2023 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © The Author(s) 2023 Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213 Waindeskar, Vaishali aut Molli, Kiran aut Koovakattil, Akhil Kuttan aut Enthalten in Ain-Shams journal of anaesthesiology [Berlin : Springer Berlin Heidelberg, 2007 15(2023), 1 vom: 23. März (DE-627)768093287 (DE-600)2732723-1 2090-925X nnns volume:15 year:2023 number:1 day:23 month:03 https://dx.doi.org/10.1186/s42077-023-00317-7 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2001 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2011 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2021 GBV_ILN_2025 GBV_ILN_2031 GBV_ILN_2038 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2050 GBV_ILN_2055 GBV_ILN_2056 GBV_ILN_2057 GBV_ILN_2061 GBV_ILN_2111 GBV_ILN_2113 GBV_ILN_2190 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4246 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 15 2023 1 23 03
language	English
source	Enthalten in Ain-Shams journal of anaesthesiology 15(2023), 1 vom: 23. März volume:15 year:2023 number:1 day:23 month:03
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Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. 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author	Mukherjee, Souvik
spellingShingle	Mukherjee, Souvik misc Case report misc Lambert-Eaton myasthenic syndrome misc Neuromuscular blocking agents misc Neuromuscular monitoring misc Spinal anesthesia An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report
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topic_title	An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report Case report (dpeaa)DE-He213 Lambert-Eaton myasthenic syndrome (dpeaa)DE-He213 Neuromuscular blocking agents (dpeaa)DE-He213 Neuromuscular monitoring (dpeaa)DE-He213 Spinal anesthesia (dpeaa)DE-He213
topic	misc Case report misc Lambert-Eaton myasthenic syndrome misc Neuromuscular blocking agents misc Neuromuscular monitoring misc Spinal anesthesia
topic_unstemmed	misc Case report misc Lambert-Eaton myasthenic syndrome misc Neuromuscular blocking agents misc Neuromuscular monitoring misc Spinal anesthesia
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title	An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report
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title_full	An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report
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title_sort	unusual case of delayed recovery from spinal anesthesia in a patient with lambert-eaton myasthenic syndrome—a case report
title_auth	An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report
abstract	Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. © The Author(s) 2023
abstractGer	Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. © The Author(s) 2023
abstract_unstemmed	Background The Lambert-Eaton myasthenic syndrome (LEMS) is a rare disorder characterized by proximal muscle weakness and autonomic dysfunction due to involvement of the neuromuscular junction A case of delayed unilateral recovery from spinal anesthesia in a patient with LEMS undergoing open cholecystectomy is described. Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. However, neurologically asymptomatic patients with good treatment compliance may also show an unusual delay in recovery from neuraxial anesthesia. © The Author(s) 2023
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title_short	An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report
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Case presentation A 42-year-old lady, on treatment for LEMS with pyridostigmine, prednisolone, and azathioprine presented with cholelithiasis and was scheduled for open cholecystectomy. Neuraxial anesthesia combined with a light plane of general anesthesia provided adequate muscle relaxation without the use of neuromuscular blocking drugs. In spite of perioperative continuation of anticholinesterases, the patient required 12 h post-surgery for complete bilateral motor recovery from spinal anesthesia. Conclusions A combination of spinal anesthesia with a light plane of general anesthesia appears to be a safe anesthetic technique for managing patients with Lambert-Eaton myasthenic syndrome undergoing open cholecystectomy. 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An unusual case of delayed recovery from spinal anesthesia in a patient with Lambert-Eaton myasthenic syndrome—a case report

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