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Acute esotropia after epidural anesthesia
Yossi Yatziv1, Chaim Stolowitch, Yoram Segev
1Department of Ophthalmology, Tel Aviv Sourasky Medical Center,Tel Aviv University, Tel Aviv, Israel. yyatziv@gmail.com
Background:
Cranial nerve palsy after dural puncture is an uncommon complication. The sixth cranial nerve is the most commonly affected because of its long intracranial course. We report a case of acute comitant esotropia that occurred after unintentional dural puncture.
Case:
A young woman presented with acute onset comitant esotropia 1 week after epidural anesthesia for a normal vaginal delivery during which the dura was unintentionally punctured. Magnetic resonance imaging revealed diffuse pachymeningeal enhancement, typically seen after dural puncture. Resolution was spontaneous.
Conclusion:
Puncture of the dura should be considered when acute strabismus is diagnosed shortly after epidural anesthesia.
