Anaesthetic Management of a Patient with Lennox– Gastaut Syndrome

Abstract

Lennox–Gastaut Syndrome (LGS) is a rare childhood-onset epileptic encephalopathy characterized by multiple seizure types, cognitive dysfunction, and a distinctive electroencephalographic pattern. Anaesthetic management in these patients is challenging due to altered drug metabolism, potential interactions with antiepileptics, and risk of perioperative seizures. We present the case of a 23-year-old woman with LGS undergoing vagal nerve stimulator (VNS) implantation under general anaesthesia. Thiopentone was chosen for induction due to its anticonvulsant and neuroprotective properties, and sevoflurane was used for maintenance owing to its smooth titration and hemodynamic stability. Intraoperative BIS monitoring guided anaesthetic depth. The perioperative course was uneventful with no seizure episodes. This case highlights the importance of individualized anaesthetic planning, vigilant monitoring, and multidisciplinary collaboration in patients with refractory epilepsy undergoing neurosurgical procedures.