A Successful Use of Electromyography-Based Neuromuscular Monitoring in a Patient With Cerebral Palsy: A Case Report

A A Pract. 2025 Oct 20;19(10):e02074. doi: 10.1213/XAA.0000000000002074. eCollection 2025 Oct 1.

Abstract

Neuromuscular monitoring in patients with cerebral palsy (CP) is technically challenging due to limb contractures and muscle atrophy. We report a case of a 28-year-old male with CP who underwent surgery under general anesthesia. Intraoperative recovery from neuromuscular block was successfully monitored using an electromyography-based neuromuscular monitor. Due to finger deformities, the abductor digiti minimi muscle was selected for monitoring. The onset of rocuronium 0.65 mg/kg was delayed and its duration markedly prolonged. Adequate recovery of neuromuscular function was confirmed with a train-of-four ratio ≥ 0.9, demonstrating the feasibility and clinical utility of TetraGraph in CP patients.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anesthesia, General
  • Cerebral Palsy* / physiopathology
  • Cerebral Palsy* / surgery
  • Electromyography* / methods
  • Humans
  • Male
  • Neuromuscular Blockade
  • Neuromuscular Monitoring* / methods
  • Neuromuscular Nondepolarizing Agents / administration & dosage
  • Rocuronium

Substances

  • Rocuronium
  • Neuromuscular Nondepolarizing Agents