Inherited neuropathy can cause postpartum foot drop

Area of Science:

• Neurology
• Anesthesiology
• Genetics

Background:

• Postpartum neurological complications affect up to 1% of deliveries.
• Anesthetic procedures are frequently implicated in postpartum neurological deficits.
• Iatrogenic nerve lesions are a significant concern with medicolegal implications.

Purpose of the Study:

• To report a case of postpartum foot drop misdiagnosed as an iatrogenic L5 root lesion.
• To highlight the role of hereditary neuropathy with liability to pressure palsies (HNPP) in postpartum neurological deficits.
• To emphasize the importance of considering genetic predispositions in the differential diagnosis of postpartum neurological issues.

Main Methods:

• Case report of a young woman with postpartum foot drop.
• Review of anesthetic and neurological history.
• Genetic testing for hereditary neuropathy with liability to pressure palsies mutation.
• Neurological assessment and diagnosis.

Main Results:

• The patient presented with foot drop following an uncomplicated epidural anesthesia.
• Initial diagnosis suggested an iatrogenic L5 root lesion.
• Subsequent genetic testing revealed a mutation for hereditary neuropathy with liability to pressure palsies.
• HNPP was identified as a likely contributing factor to the postpartum neuropathy.

Conclusions:

• Anesthesiologists should consider hereditary neuropathies in the differential diagnosis of postpartum neurological deficits.
• Undiagnosed hereditary neuropathy with liability to pressure palsies can mimic iatrogenic nerve injuries.
• A thorough clinical history and genetic assessment are vital for accurate diagnosis and management of postpartum neurological complications.