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[Lower limb monoplegia and dissociated hypoesthesia after peridural anesthesia]
M F Fernández1, B Dachy, G Demeurisse
1CHU Brugmann, Bruxelles, Belgique.
Revue Neurologique
|September 16, 1999
Summary
Neurological complications like spinal cord injury can occur after epidural anesthesia. This case highlights unilateral leg paralysis and sensory loss due to spinal cord infarction following the procedure.
Area of Science:
- Neurology
- Anesthesiology
- Vascular Medicine
Background:
- Epidural anesthesia is a common procedure with known neurological risks, including spinal cord injury.
- Reported neurological sequelae encompass epidural hematoma, spinal cord ischemic injury, and lumbosacral nerve root injury.
Observation:
- A case of monoplegia (paralysis) of the right lower limb was observed.
- This was accompanied by ipsilateral loss of pain and temperature sensation.
Findings:
- Magnetic Resonance Imaging (MRI) revealed a right centrolateral infarction in the spinal cord's gray matter below the D8 level.
- Potential causes include hypotension, vascular spasm, trauma, arteriosclerosis, or increased epidural space pressure.
Implications:
- Unilateral neurological deficits following epidural anesthesia may stem from injury to specific spinal arteries, such as the sulcocommissural or duplicated anterior spinal artery.
- Understanding these mechanisms is crucial for preventing and managing neurological complications of epidural anesthesia.
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