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Recurrent psychogenic paresis after dural puncture in a parturient
1Department of Anesthesiology, Stony Brook University Medical Center, Stony Brook, NY 11794, USA.
International Journal of Obstetric Anesthesia
|March 12, 2013
Summary
A parturient experienced leg weakness after cesarean delivery, diagnosed as psychogenic paresis. This rare recurrent neurological dysfunction after dural puncture highlights conversion disorder in obstetrics.
Area of Science:
- Neurology
- Obstetrics
- Psychiatry
Background:
- A 29-year-old parturient developed lower extremity weakness post-cesarean delivery.
- Past medical history included asymptomatic Arnold Chiari Type I malformation and asthma.
Observation:
- Spinal anesthesia failed, requiring general anesthesia.
- Postoperatively, bilateral leg weakness persisted for 4-6 hours.
- Magnetic resonance imaging revealed no spinal hematoma.
Findings:
- Neurological assessment diagnosed psychogenic paresis, a conversion disorder.
- This was the patient's second occurrence of neurological dysfunction after dural puncture.
- Previous symptoms occurred during gestation after a lumbar puncture.
Implications:
- Psychogenic paresis is rarely reported, especially post-spinal anesthesia in parturients.
- This case highlights recurrent conversion disorder in obstetrics.
- Reviews risk factors, etiology, and management of recurrent conversion disorder.
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