Management of patients with neurological and psychiatric disorders

Stroke, neuromuscular disorders, epilepsy and psychiatric disease are amongst the most common neurological conditions encountered in patients presenting for surgery. In some instances, patients may require surgery as a direct result of their neurological disease. Both anaesthesia and surgery may exacerbate pre-existing disease, and there may be important interactions between drugs used to treat neurological disease and drugs used in the perioperative period. Patients with muscular weakness, immobility, sensory and autonomic neuropathy, or cognitive impairment are in an increased risk of perioperative complications. This article focuses on commonly encountered conditions and their management in the perioperative period.