Neuromyelitis optica: An anesthetic challenge

Neuromyelitis optica (NMO), a rare devastating demyelinating syndrome involving optic neuritis and myelitis, poses a challenge to anesthesiologists. Here, we present the anesthetic management of a diagnosed case of NMO posted for total hip replacement. Although literature documenting adverse outcomes with both general anesthesia (GA) and spinal anesthesia (SA), more so with SA, it should always be considered if benefits outweigh the risk of GA. An uneventful perioperative period in the previous two surgeries favored SA as an anesthetic technique for consecutively third time in this case with smooth recovery.