# Anesthetic Management of a Patient With Acute Necrotizing Encephalopathy Type 1

## TL;DR

This case report details the anesthetic care of a child with a rare brain condition during hip surgery, highlighting the challenges and strategies used.

## Contribution

The paper provides a detailed anesthetic management approach for a rare neurological condition with limited existing literature.

## Key findings

- ANE1 shares symptoms and pathology with mitochondrial disorders, complicating anesthetic choices.
- Perioperative management included careful medication selection and monitoring to avoid triggering seizures or metabolic crises.
- The case highlights the importance of a multidisciplinary approach for patients with rare neurological conditions.

## Abstract

Acute necrotizing encephalopathy (ANE) is a progressive neurodegenerative condition that often arises after exposure to a variety of viruses and systemic infections, including influenza and SARS-CoV-2. It typically presents with developmental delay, seizures, dysarthria, and ataxia. Acute necrotizing encephalopathy type 1 (ANE1) is recurrent, and familial cases have been associated with mutations in the RAN-binding protein 2 (RanBP2) gene. The disease shares symptomatic and pathological resemblance with mitochondrial metabolic disorders. In this case report, we present the anesthetic management of a seven-year-old boy with ANE1 who underwent total hip reconstruction. Literature on the anesthetic management of such patients is sparse, and we discuss the patient's perioperative anesthetic management, including medications, monitoring, and care, along with a literature review.