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VOLUME 5 , ISSUE 3 ( July-September, 2022 ) > List of Articles

CASE REPORT

A Case of Myasthenia Gravis with Steroid-induced Bilateral Avascular Necrosis Neck of Femur Posted for Bilateral Core Decompression

S Dhanasekar, T Krishna Prasad, Sabarigirivasan Kumbasantharam

Keywords : Non-relaxant anesthesia, Perioperative steroid therapy, Postoperative myasthenic crisis

Citation Information : Dhanasekar S, Prasad TK, Kumbasantharam S. A Case of Myasthenia Gravis with Steroid-induced Bilateral Avascular Necrosis Neck of Femur Posted for Bilateral Core Decompression. 2022; 5 (3):69-72.

DOI: 10.5005/jp-journals-10082-03134

License: CC BY-NC 4.0

Published Online: 01-07-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Postoperative myasthenic crisis (POMC) is one of the leading causes of respiratory failure, requiring intubation or mechanical ventilation within 24 hours to 7 days following surgery in myasthenia gravis (MG) patients. Its incidence ranges from 11.5 to 18.2% in MG patients. A 32-year-old male, coming from Chengalpattu belonging to socioeconomic class III was a known case of MG for 1½ years, belongs to grade I of Osserman classification (ocular weakness without bulbar involvement) and was on oral prednisolone 30 mg/day and pyridostigmine 60 mg/day. The patient was diagnosed with a bilateral avascular necrosis neck of the femur, posted for core decompression. Various studies were aimed to develop and validate a simple clinical prediction score for POMC risk based on data from patients with MG. With this clinical prediction score, following certain anesthesia strategies will minimize its incidence and make their perioperative journey safe.


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