Total Unilateral Ophthalmoplegia Following Spinal Anesthesia

Shapira, Theodore M.; Schall, Sam; Rodin, Max

doi:10.1016/0002-9394(50)91622-9

Cited by 2 publications

(2 citation statements)

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“…[14][15][16] In 6 other cases of affected cranial nerves IV and III palsy, cranial nerve VI was also affected. [17][18][19][20][21][22] Extraocular muscle palsy onset occurred after 7.30 ± 4.09 days (range, 1-21 days) and lasted 80.10 ± 80.67 days (range, 1-630 days). Diplopia was accompanied by PDPH in 75.43% of cases and was reversible in 85.09% of them.…”

Section: Resultsmentioning

confidence: 99%

“…20 We found 2 cases of isolated cranial nerve III palsy 15,16 and 6 cases of cranial nerve IV or III palsy combined with cranial nerve VI palsy. [17][18][19][20][21][22] A study by Thomke et al informed that the incidence of cranial nerve VI palsy after LP was 1 per 5800, 49 whereas it was 1 per 400 in the study by Follens et al 17 Heyman et al assessed the range of abducens palsy after LP, which was between 1 per 5000 and 1 per 8000. 27 The incidence of VI palsy after myelographies has been reported to be 1 per 500, 8 and some series have found it to be between 1 per 5000 and 1 per 8000 cases after subarachnoid anesthesia.…”

Section: Resultsmentioning

confidence: 99%

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Ocular Motor Palsy After Spinal Puncture

del-Río-Vellosillo

García-Medina

Pinazo-Durán

et al. 2017

Regional Anesthesia and Pain Medicine

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Ocular motor palsy is a rare but alarming complication of subarachnoid puncture. In order to better understand this condition, a literature search was performed in English of PubMed articles for cranial nerves III, IV, and VI palsies after spinal puncture. Sixty-five articles (dated 1930-2015) were identified, and 114 cases were obtained for analysis. Subarachnoid anesthesia was the most frequent cause (45.6%), with a higher incidence for females than males. The age of patients was 40.24 ± 13.35 years (age range, 6-71 years). The sixth cranial nerve was the most commonly involved (92.1%), with higher frequency in the right eye. Palsy onset started 7.30 ± 4.09 days after puncture. Duration in reversible cases was 80.10 ± 80.67 days. Paresia was permanent in 13 patients, but only 2 patients required extraocular muscle surgery. Treatments included the horizontal position along with analgesics, fluid therapy, and corticosteroids. The usefulness of blood patch remains controversial. It is important for anesthesiologists and other physicians to recognize the cardinal features of this process to ensure early diagnosis, avoid unnecessary tests, and guide appropriate treatment.

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