ISOLATED ABDUCENS NERVE PALSY AFTER LUMBAR PUNCTURE - A CASE REPORT

Area of Science:

• Neurology
• Neuro-ophthalmology

Background:

• Isolated abducens nerve palsy is a rare complication following lumbar puncture.
• Literature primarily documents this complication in anesthesiology after spinal anesthesia, not neurology.
• The exact incidence of post-lumbar puncture abducens nerve palsy remains unknown.

Observation:

• A 32-year-old male with headache underwent lumbar puncture for etiological investigation.
• Two days post-procedure, the patient developed isolated right abducens nerve palsy.
• The patient had pre-existing cavernous malformation and developmental venous anomalies.

Findings:

• The case highlights a potential neurological complication of lumbar puncture.
• Diagnostic plans included noninvasive optic nerve sheath sonography and repeat MRI.
• Treatment with epidural blood patch was proposed but refused by the patient.

Implications:

• Emphasizes the importance of considering lumbar puncture as an etiology for abducens nerve palsy.
• Highlights the need to exclude other causes before attributing palsy to the procedure.
• Aims to increase awareness among clinicians, particularly younger specialists, regarding this rare complication.