Here is My Question:
I'm a 35 year old female diagnosed 1 year ago with RRMS, but based on symptoms, we suspect I have had it for 15 to 20 years. I had surgery 2 months ago, and an exacerbation involving low blood pressure, neck spasms, and bladder retention. I stayed inpatient in the Step Down Unit for 4 days after what was supposed to be an outpatient procedure. My MS Specialist was informed and involved in all phases of care and did not seem too concerned about the incident.
I had a consultation today with a different plastic surgeon about a breast augmentation with local anesthesia and/or twilight sedation. The surgeon refused to do the procedure, citing the adverse effects of lidocaine on MS. He said that the effects after the aforementioned surgery were most likely due to the large amounts of lidocaine and epinephrine injected into incision sites to control bleeding and help with pain management. He also said that with my history, I should never undergo any outpatient surgery procedure. I asked about the -caine injections for dental work, and he was leary about those as well; they could either cause permanent nerve damage or no pain relief/fast metabolizing of the numbing agent, thus causing severe pain during dental work.
I have 21+ lesions on my brain, C2, T3, and T4 spinal cord lesions.
I know that cosmetic surgery isn't contraindicated just because a patient has MS, but is there any merit to what this surgeon had advised?
Thank you for your advice.
Find a new surgeon/anesthetist. This issue comes up more than you might got think. The literature suggests an association between MS attacks and anesthesia; however, there is no established causal relationship. I suspect that heat/temperature change that can occur with surgery and anesthesia may bring out "pseudo-attacks" of older symptoms from prior nervous system injury due to MS.
A. Scott Nielsen MD MMSc
Neurologist and MS Specialist at Kaiser Permanente
PLEASE NOTE: The information/opinions on this site should be used as an information resource only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.
PLEASE NOTE: This information/opinions on this site should be used as an information source only. This information does not create any patient-HCP relationship, and should not be used as a substitute for professional diagnosis and treatment. Please consult your health care provider before making any healthcare decisions or for guidance about a specific medical condition.