Flaccid Leg Paralysis Caused by a Thoracic Epidural Catheterization: A Case Report

Abstract

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection.

Continuous epidural catheter for anaesthesia management and post-op pain relief in colorectal surgery, complicated by epidural haematoma and bilateral paraplegia: A case report

“…Despite low incidence, epidural catheter-induced complications including epidural haematoma, abscess, spinal cord injury or infarction have been reported in the literature. These complications remain extremely rare, with an estimated incidence rate between 0.006% and 0.03%, yet they are often associated with prolonged recovery time and devastating impact on patient functionality [ 8 ].…”

Acute transverse myelitis arising after combined general and thoracic epidural anesthesia

“…Severe neurologic complications following postoperative epidural analgesia occur infrequently or rarely with a reported prevalence of only 0.005–0.070 % [ 1 ]. Most recognized are epidural hematoma or abscess, whereas no systematic reviews, which show the relationship between anesthetic procedures or medications and acute transverse myelitis, have been published, and only few cases of acute myelitis after thoracic epidural anesthesia have been reported [ 2 , 3 ]. In this report, we present a patient who postoperatively developed acute myelitis with an epidural catheter in situ.…”