Lower limb neuropathy after spinal anesthesia in a patient with latent thiamine deficiency

Al-Nasser, Bassam; Callenaere, Claude; Just, Alain

doi:10.1016/j.jclinane.2006.04.007

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…Vitamin deficiency syndromes may predispose to neuropathy and perianaesthesia myoclonus [11,12]. A possible contributory factor to the myoclonus in Patient 3 is the mild vitamin B12 deficiency.…”

Section: Discussionmentioning

confidence: 99%

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Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

et al. 2009

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IntroductionPerioperative spinal myoclonus is extremely rare. Many anaesthetists and perioperative practitioners may not diagnose or manage this complication appropriately when it occurs. This case report of unusual acute spinal myoclonus following regional anaesthesia highlights certain aspects of this rare complication that have not previously been published.Case presentationsA series of four consecutive patients who developed acute lower-limb myoclonus following spinal or epidural anaesthesia are described. The case series occurred at three different hospitals and involved four anaesthetists over a 3-year period. Two Caucasian men, aged 90-years-old and 67-years-old, manifested unilateral myoclonus. Two Caucasian women, aged 64-years-old and 53-years-old, developed bilateral myoclonus. Myoclonus was self-limiting in one patient, treated with further regional anaesthesia in one patient and treated with intravenous midazolam in two patients. The overall outcome was good in all patients, with no recurrence or sequelae in any of the patients.ConclusionThis case series emphasizes that spinal myoclonus following regional anaesthesia is rare, has diverse pathophysiology and can have diverse presentations. The treatment of perioperative spinal myoclonus should be directed at the aetiology. Anaesthetists and perioperative practitioners who are unfamiliar with this rare complication should be reassured that it may be treated successfully with midazolam.

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Section: Discussionmentioning

confidence: 99%

“…However, the degree of deficiency in our patient was mild and she did not require vitamin B12 therapy for the resolution of myoclonus. Lower-limb neuropathy after spinal block has been reported in a case of thiamine deficiency [12]. …”

Section: Discussionmentioning

confidence: 99%

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

et al. 2009

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“…Another paper reported a patient with new onset LEs weakness and paresthesia two weeks after spinal anesthesia. The patient was found to have axonal neuropathy related to thiamine de ciency and improved after thiamine supplementation 4 . A case of neurotoxicity manifesting as paresthesia was also reported after EA with Ropivacaine in a patient with diabetic sensory polyneuropathy 5 .…”

Section: Discussionmentioning

confidence: 99%

Neurotoxicity post-epidural anesthesia in a patient with Vitamin B12 deficiency: a case report

Ibrahim,

Maalouf

2024

Preprint

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Background: Neurotoxicity have been reported after central neuraxial block. Some metabolic disturbances (thiamine deficiency, diabetes) were identified as contributing factor. Case presentation: We describe a young woman with vitamin B12 deficiency who developed persistent lower extremity weakness and hypoesthesia for weeks after epidural anesthesia. Initial examination revealed bilateral distal lower extremities weakness and decreased sensations. Serial neurologic examinations showed improved motor and sensory findings. An injected lumbosacral MRI was unremarkable. Vitamin B12 level was very low. The patient received physiotherapy and Vitamin B12 supplementation. Nerve conduction study and electromyography on day-23 post-epidural anesthesia revealed evidence of peripheral nerve injury. Conclusion: This case is the first to recognize vitamin B12 deficiency as a predisposing factor for the development of neurotoxicity following epidural anesthesia, it also emphasizes the importance of timely identification of vitamin deficiencies in patients developing neurotoxicity following central neuraxial blocks.

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“…Vitamin deficiency may predispose to neuropathy and myoclonus 7,8 . But neither of cases have reported that.…”

Section: Discussionmentioning

confidence: 99%

Spinal Myoclonus a Rare Complication Following Administration of Spinal Anaeasthesia – A Case Report

Kandearachchi,

Menike,

Madawala

et al. 2024

Sri Lankan J Anaesthesiol

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Spinal myoclonus is a rare complication following spinal anesthesia. Transient myoclonic jerks are referred as spinal myoclonus and it is diagnosed by exclusion. This case report describes a successful management of spinal myoclonus after spinal anesthesia.A 48 year old, woman who had undergone incision and drainage under spinal anesthesia, developed truncal myoclonus 45 minutes following induction of anesthesia. It was effectively alleviated through administration of IV midazolam.

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Lower limb neuropathy after spinal anesthesia in a patient with latent thiamine deficiency

Cited by 5 publications

References 9 publications

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

Neurotoxicity post-epidural anesthesia in a patient with Vitamin B12 deficiency: a case report

Spinal Myoclonus a Rare Complication Following Administration of Spinal Anaeasthesia – A Case Report

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Lower limb neuropathy after spinal anesthesia in a patient with latent thiamine deficiency

Cited by 5 publications

References 9 publications

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

Central neuraxial anaesthesia presenting with spinal myoclonus in the perioperative period: a case series

Neurotoxicity post-epidural anesthesia in a patient with Vitamin B12 deficiency: a case report

Spinal Myoclonus a Rare Complication Following Administration of Spinal Anaeasthesia &ndash; A Case Report

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Spinal Myoclonus a Rare Complication Following Administration of Spinal Anaeasthesia – A Case Report