Four young patients, including a 7-year-old girl with Aicardi syndrome, an 11-year-old boy with Lennox-Gastaut syndrome, a 22-year-old man with epilepsy due to childhood encephalitis, and a 17-year-old girl with Rett syndrome, were scheduled to undergo extracorporeal shock wave lithotripsy (ESWL) for urolithiasis. Epilepsy in all of the patients was well controlled by medication. Series of ESWL treatment were safely performed under general anesthesia with tracheal intubation. We recommend that maintenance of anesthesia be performed by sevoflurane and nitrous oxide, which can increase threshold of epileptic stroke, and controlled ventilation with a muscle relaxant should be performed to prevent lung or renal injury by the shock wave of ESWL.
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