General Anesthesia in a Pediatric Patient with Leigh Syndrome: A Case Report and Literature Review

Leigh syndrome is a rare inherited neurodegenerative disorder of infancy and childhood and is characterized by developmental delay of nervous system function and respiratory abnormalities. The latter includes breathing difficulties, aspiration, hypoventilation, and apnea, and it is known that surgery and general anesthesia may cause acute exacerbations with respiratory failure. These patients may also develop episodes of lactic acidosis leading to respiratory failure and death. Owing to the rarity and life-threatening nature of the condition, however, there is no standard protocol for anesthetic management. Based on our own experience of evaluating and performing percutaneous gastrotomy under general anesthesia in a patient with Leigh syndrome, we discuss the attendant dilemmas and solutions and propose a working protocol with an integrated anesthetic plan.