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Central sensory-motor deficit after uneventful single-dose spinal morphine administration in a patient with

Claude Lentschener1, Bertrand Dousset, Mathieu Zuber

  • 1Department of Anesthesia and Critical Care, Faculté de Médecine, Université Paris-Descartes, Assistance Publique-Hôpitaux de Paris, Hôpital Cochin, Paris, France. claude.lentschener@cch.aphp.f.

Anesthesia and Analgesia
|October 22, 2009
PubMed

Insights

A patient developed persistent neurological deficits after spinal morphine, potentially linked to hemiplegic migraine and spinal cord vascular issues. Recurrent hemiplegic attacks suggest a complex interaction between morphine and underlying vascular dysfunction.

Area of Science:

  • Neurology
  • Pharmacology

Background:

  • Hemiplegic migraine involves central nervous system vascular alterations and temporary neurological deficits.
  • Spinal ischemia can lead to lasting motor dysfunction, as previously reported.

Observation:

  • A patient experienced persistent neurological deficits after a single spinal dose of morphine (400 microg).
  • Symptoms included left quadriceps weakness, saddle anesthesia, and central urinary retention, persisting for 3 years.
  • The patient also had recurrent episodes of acute headache with left-sided hemiplegia, resolving within 24 hours, suggestive of hemiplegic migraine.

Findings:

  • This case presents a permanent neurological deficit following spinal morphine administration in a patient without prior neurological conditions.
  • The persistent deficits and recurrent hemiplegic episodes suggest a potential link between spinal morphine, hemiplegic migraine, and spinal cord vascular dysfunction.

Implications:

  • This case highlights a potential risk of permanent neurological deficits from spinal morphine, particularly in patients with underlying vascular conditions like hemiplegic migraine.
  • Further research is warranted to understand the interaction between opioids, spinal cord vascular health, and neurological outcomes.

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