# Bulbar-Onset Amyotrophic Lateral Sclerosis Unmasked by General Anesthesia: A Case Report

## TL;DR

A case of bulbar-onset ALS was identified after a patient experienced postoperative extubation failure, highlighting the disease's impact on anesthesia and recovery.

## Contribution

This case report highlights the unmasking of bulbar-onset ALS through postoperative extubation failure, emphasizing its relevance to anesthetic management.

## Key findings

- Bulbar-onset ALS was diagnosed following postoperative extubation failure in a 51-year-old patient.
- The case underscores the importance of considering ALS in patients with difficult postoperative ventilatory weaning.
- Anesthetic agents may exacerbate symptoms and affect recovery in undiagnosed ALS patients.

## Abstract

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease that primarily affects the motor neurons in the brain and spinal cord, resulting in severe muscular weakness, atrophy, and loss of motor control. Patients with ALS are often highly sensitive to anesthetic drugs, specifically neuromuscular blocking agents, which can exacerbate muscle weakness and contribute to prolonged postoperative recovery times. In this article, we report a case of bulbar ALS diagnosed after postoperative extubation failure in a 51-year-old patient. Practitioners should consider this disease in cases of difficult postoperative ventilatory weaning and should be aware of the impact of surgery and anaesthesia on disease progression.