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Lateral rectus palsy: complication following opiate pump placement.
Robert E Windsor1, Samuel Thampi
1Georgia Pain Physicians, 2550 Windy Hill Rd., Suite 215, Marietta, GA 30067, USA. rwindsor@aol.com
Pain Physician
|July 27, 2006
Summary
A patient experienced blurred vision and double vision after receiving an opiate pump for chronic pain. These symptoms, including a temporary nerve palsy, resolved with conservative management, highlighting potential visual side effects of drug administration systems.
Area of Science:
- Neurology
- Ophthalmology
- Pain Management
Background:
- Chronic lumbar radiculopathy and multiply operated spine often necessitate advanced pain management strategies.
- Implantable drug administration systems (DAS) are utilized for continuous pain relief.
- Opiate pump therapy can present with various side effects, necessitating careful monitoring.
Purpose of the Study:
- To report a case of visual disturbances following opiate pump placement.
- To investigate the potential link between drug administration systems and neurological/ophthalmological complications.
- To describe the clinical presentation and resolution of symptoms.
Main Methods:
- Case report of a 46-year-old patient.
- Detailed medical history including symptoms post-opiate pump (Drug Administration System, DAS) placement.
- Neurological examination and specialist consultation.
Main Results:
- The patient developed blurred vision, positional headaches, and diplopia after DAS placement.
- Neurological examination confirmed a left lateral rectus palsy.
- Symptoms gradually resolved with conservative management.
Conclusions:
- Visual disturbances, including cranial nerve palsies, can be a rare complication of opiate pump therapy.
- Prompt diagnosis and supportive care can lead to symptom resolution.
- Ophthalmological and neurological monitoring is crucial in patients with implanted drug administration systems.