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Intrinsic spinal cord lesions complicating epidural anaesthesia and analgesia: report of three cases

P A Wilkinson1, A Valentine, J M Gibbs

  • 1Department of Clinical Neurosciences, Royal Free and University College Medical School, Rowland Hill Street, London NW3 2PF, UK. philwilkinson27@hotmail.com

Journal of Neurology, Neurosurgery, and Psychiatry
|March 23, 2002
PubMed

Insights

Rare serious neurological complications from epidural anesthesia can cause spinal cord lesions. Three patients experienced motor and sensory deficits after catheterization, with MRI showing cord lesions and potential hydromyelia.

Area of Science:

  • Neurology
  • Anesthesiology
  • Radiology

Background:

  • Epidural anesthesia and analgesia are common procedures.
  • Serious neurological complications are rarely reported.

Observation:

  • Three patients developed intrinsic spinal cord lesions post-epidural catheterization.
  • Early motor and sensory impairment were noted.
  • MRI revealed extensive, paracentral, high signal intensity lesions on T2-weighted images.

Findings:

  • The lesions were likely caused by direct spinal cord trauma during catheterization.
  • Subsequent fluid injection may have led to localized hydromyelia.
  • Prognosis included gradual motor recovery but persistent sensory deficits and pain.

Implications:

  • Highlights a rare but serious complication of epidural procedures.
  • Emphasizes the importance of careful technique and early recognition.
  • Suggests potential for long-term neurological sequelae despite recovery.

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