Anesthetic considerations for the patient with Huntington's disease

Huntington's disease (HD) is an autosomal, dominantly inherited disease with symptoms manifesting late in life. Patients suffer from motor dysfunction and progressive mental deterioration. HD patients present a number of anesthetic challenges as they are usually elderly, malnourished, and at risk for aspiration. Previous reports on anesthesia for patients with HD have warned that sodium pentothal and succinylcholine cause prolonged apnea in this patient population. In this article, a 78-year-old female presented for cataract extraction. Although her movement disorder was under good control with haloperidol, a general anesthetic was chosen for the procedure in order to ensure a tranquil surgical field. This article presents the successful management of a patient with HD using a balanced anesthetic technique combining judicious amounts of narcotics and barbiturates with isoflurane.