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Updated: Jul 9, 2026
03:14
Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia
Published on: January 31, 2025
[Acute transverse myelitis after obstetric epidural anesthesia]
N López Ariztegui1, B Mondéjar Marín, R García Montero
1Servicio de Neurología. Hospital Virgen de la Salud. Toledo. nlopeza@meditex.es
Neurologia (Barcelona, Spain)
|November 28, 2007
Summary
This case study details a parainfectious acute transverse myelitis in a postpartum patient, potentially linked to epidural anesthesia. Prompt treatment with methylprednisolone led to a full recovery without relapse.
Area of Science:
- Neurology
- Immunology
Background:
- Acute transverse myelitis (ATM) is a spinal cord disorder causing motor, sensory, and sphincter dysfunction.
- Diverse etiologies contribute to ATM, necessitating thorough differential diagnosis.
Observation:
- A 32-year-old female presented with acute bladder dysfunction, fever, and lower limb neurological deficits post-delivery with epidural anesthesia.
- Cerebrospinal fluid analysis revealed lymphocytic pleocytosis and elevated protein, with negative infectious workup.
- Spinal MRI demonstrated cord swelling and T2 hyperintensities without contrast enhancement.
Findings:
- Exclusion of common ATM causes like multiple sclerosis, infections, and infarcts.
- Diagnosis of parainfectious acute transverse myelitis was established.
- Epidural anesthesia was considered a potential, albeit incidental, contributing factor.
Implications:
- Highlights the importance of considering parainfectious etiologies in postpartum patients with myelitis.
- Demonstrates the efficacy of high-dose intravenous methylprednisolone in treating ATM.
- Suggests potential, though unproven, role of epidural anesthesia in precipitating or contributing to ATM.
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