Perioperative management of multiple sclerosis

Abstract

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system (CNS), which affects young adults with a chronic clinical course. It is characterized by the appearance of neurological symptoms in the form of periodic outbreaks, which can be maintained and/or progress over time, causing residual disability.
The perioperative management of patients with neurological diseases is usually complex, since it requires taking into account the alterations that anesthesia can cause on pre-existing dysfunctions, as well as the effect that the disease and its treatment have on the functioning of our drugs.
As we will see later, the most important thing when caring for a patient with MS will be to have a good knowledge of the disease as well as to carry out a thorough preoperative evaluation. In this way they can be intervened safely.
Here we present a brief review of the currently available evidence on the pathophysiology, clinical presentation, diagnosis, treatment, and anesthetic implications of patients with MS. To achieve this, a systematic bibliographic search of articles in the PubMed database has been carried out using the terms "multiple sclerosis", "anesthesia" and "perioperative".
In this way, it is concluded that, with a thorough preoperative evaluation and a thorough knowledge of the disease, patients with MS can be operated on safely.