SPINAL-ANESTHESIA IN A PATIENT WITH NARCO LEPSY-CATAPLEXY

A 44-year-old patient, with narcolepsy-cataplexy, underwent surgery fo r lumbar disk hernia under spinal anaesthesia. Our purpose was to prev ent an interaction between the patient's disease and general anaesthet ic agents with the risk of post-operative hypersomnia. During surgical procedure, two narcolepsy fits occurred, without clinical consequence s. The postoperative course was uneventful. However, spinal anaesthesi a cannot be considered as a technique of choice because of the risk of narcolepsy-cataplexy fits with loss of consciousness and atonia, duri ng regional anaesthesia. General anaesthesia seems to be the best choi ce for these patients cholinergic agents and mainly the alpha 1 adrene rgic blocking drugs are contra-indicated as they increase the risk of narcolepsy-cataplexy fits. Anaesthetic sleep, narcolepsy, cataplexy an d epilepsy are clinically rather similar. The EEG does not allow to di fferentiate between narcolepsy and anaesthetic sleep, whereas cataplex y and epilepsy result in specific EEG patterns.