[Acute transverse myelitis after obstetric epidural anesthesia]

Acute transverse myelitis is an acute or subacute disorder of the spinal cord resulting in motor, sensory and sphincter dysfunction secondary to various causes.

We present a 32 year-old female patient with an acute episode of bladder dysfunction and fever, followed by motor and sensory dysfunction in legs with sensory spinal level at D2-D3, two weeks after an eutocic delivery with uncomplicated epidural anesthesia. The cerebrospinal fluid (CSF) showed mild lymphocytic pleocytosis, high protein levels with normal glucose concentration, absence of oligoclonal bands and negative serum and CSF virology screening. The cervicodorsal magnetic resonance imaging showed widening of the spinal cord with diffuse patchy hyperintensity on the C6-D1 and D2-D5 levels without contrast enhancement. The patient was treated with intravenous high doses of methylprednisolone with favorable outcome and complete recovery within one year and no relapses two years after the episode.

The main etiologies of non-compressive acute myelopathy as multiple sclerosis, systemic diseases, spinal cord infarct and direct infections have been ruled out with the complementary examinations. We consider that our patient had a parainfectious acute transverse myelitis and epidural anesthesia could be an incidental but possible contributing factor.