Chemical meningitis after cervical transforaminal epidural steroid injection: a case report

Lee, Min Young; Lee, Hee Jin

doi:10.1177/0300060521993974

Cited by 6 publications

(7 citation statements)

References 14 publications

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“…injection with a mixture of lidocaine, hyaluronidase, placenta hydrolysate, and normal saline. 9 In this patient, it was difficult to delineate the cause of the condition using only the initial CSF analysis, without culture. However, due to the rapid onset of symptoms after the procedure, about 2.5 h, the patient was symptomatically treated with analgesics and fluid management with the assumption of chemical meningitis and had rapid relief after 3 days.…”

Section: Discussionmentioning

confidence: 94%

Drug‐induced aseptic meningitis after an interlaminar lumbar epidural steroid injection

Nguyen,

Kant,

Cartagena

et al. 2023

Pain Practice

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BackgroundThis case report describes a rare instance of drug‐induced aseptic meningitis after an interlaminar lumbar epidural steroid injection.Case PresentationA 74 year‐old female patient presented to the ED post‐procedure day three after an L4‐L5 interlaminar lumbar epidural steroid injection with fever, nausea, and vomiting. The patient had previously undergone numerous lumbar epidurals without complications and used identical medications, which included 1% lidocaine, iohexol contrast, methylprednisolone (Depo‐medrol), and normal saline. Pertinent labs included a WBC of 15,000 cells/μL. Lumbar MRI revealed L4‐S1 aseptic arachnoiditis. Two bone scans with Gallium and T‐99 confirmed no infectious process. The patient then had a second admission months later with similar presenting symptoms and hospital course after repeating the lumbar epidural steroid injection. Lumbar MRI and CSF studies confirmed aseptic meningitis.ConclusionThis patient's repeated admissions from aseptic meningitis were likely caused by irritation of the meningeal layers from a medication used during the procedure.

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Section: Discussionmentioning

confidence: 94%

Drug‐induced aseptic meningitis after an interlaminar lumbar epidural steroid injection

Nguyen,

Kant,

Cartagena

et al. 2023

Pain Practice

View full text Add to dashboard Cite

show abstract

“…In our study, no serious complication was observed in either group, while one patient had severe headache. Acute chemical meningitis may rarely develop after ESI [32].…”

Section: Discussionmentioning

confidence: 99%

Comparative effects of epidural steroid injections on disc bulging and disc protrusion in patients with discogenic low back pain

ÇETİN

Şah

Zengin

et al. 2023

Preprint

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Objective In this study, we aimed to examine the effect of epidural steroid administration (ESI) on disc bulging and disc protrusion in patients with discogenic low back pain. Materials and Methods The prospective randomized study reviewed medical records of 71 patients with discogenic low back pain who were radiologically proven as disc bulging and disc protrusion with or without radicular pain and did not require surgery at Neurosurgery Department between June 2021 and June 2022. All the patients underwent ESI and attended regular follow-up visits for a period of 6 months. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were assessed before the procedure, one week after the procedure, one month after the procedure, and six months after the procedure. Results There was no significant difference between patients with disc bulging and disc protrusion in terms of demographic characteristics. In both groups, both VAS and ODI scores showed a significant decrease in the post-procedure period compared to the pre-procedure period. However, there was no significant difference between the two groups with regard to the reduction rate between post-procedure 1st week VAS scores and pre-procedure VAS scores. Conclusion The results indicated that lumbar interlaminar steroid injection is an effective treatment for disc bulging and discogenic pain due to protrusion and that both groups benefited from ESI administration. Additionally, except for the first week of injection, relief due to the use of epidural steroids was observed to be greater in the Disc Protrusion group compared to the Disc Bulging group.

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“…In our study, no serious complication was observed in either group, while one patient had severe headache. Acute chemical meningitis may rarely develop after ESI [29].…”

Section: Discussionmentioning

confidence: 99%

Comparative effects of epidural steroid injections on disc bulging and disc protrusion in patients with discogenic low back pain

ÇETİN

Şah

Zengin

et al. 2022

Preprint

View full text Add to dashboard Cite

Objective Discogenic low back pain is a widespread disorder around the world. Numerous methods have been developed and continue to be developed in the treatment of discogenic low back pain. In this study, we aimed to examine the effect of epidural steroid administration (ESI) on disc bulging and disc protrusion in patients with discogenic low back pain. Materials and Methods The prospective randomized study reviewed medical records of 71 patients with discogenic low back pain who were radiologically proven as disc bulging and disc protrusion with or without radicular pain and did not require surgery at Neurosurgery Department between June 2021 and June 2022. All the patients underwent ESI and attended regular follow-up visits for a period of 6 months. Visual Analogue Scale (VAS) and Oswestry Disability Index (ODI) scores were assessed before the procedure, one week after the procedure, one month after the procedure, and six months after the procedure. Results There was no significant difference between patients with disc bulging and disc protrusion in terms of demographic characteristics. In both groups, both VAS and ODI scores showed a significant decrease in the post-procedure period compared to the pre-procedure period. However, there was no significant difference between the two groups with regard to the reduction rate between post-procedure 1st week VAS scores and pre-procedure VAS scores. Conclusion The results indicated that lumbar interlaminar steroid injection is an effective treatment for disc bulging and discogenic pain due to protrusion and that both groups benefited from ESI administration. Additionally, except for the first week of injection, relief due to the use of epidural steroids was observed to be greater in the Disc Protrusion group compared to the Disc Bulging group.

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Chemical meningitis after cervical transforaminal epidural steroid injection: a case report

Cited by 6 publications

References 14 publications

Drug‐induced aseptic meningitis after an interlaminar lumbar epidural steroid injection

Drug‐induced aseptic meningitis after an interlaminar lumbar epidural steroid injection

Comparative effects of epidural steroid injections on disc bulging and disc protrusion in patients with discogenic low back pain

Comparative effects of epidural steroid injections on disc bulging and disc protrusion in patients with discogenic low back pain

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