A Case Report of Successful Vaginal Delivery for Cauda Equina Syndrome Combined with Complex Regional Pain Syndrome
Hwawon Lim1, Yumi Shin1, Hyunjo Kim2
1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
Background:
Cauda equina syndrome (CES) is defined as a complex clinical entity associated with simultaneous compression of several or all lumbosacral spine nerve roots. Complex regional pain syndrome (CRPS) is a chronic and non-treatable pain condition resulting in lifetime disability due to a tendency to relapse. Both diseases present with chronic pain and neuropathy. We aimed to report a unique patient with successful pregnancy and delivery although she had both CES and CRPS.
Case Presentation:
Here we present a female who was diagnosed as CES with CRPS after fall from a high building about 10 years previously. She became pregnant after two miscarriages, maintained her pregnancy with numerous pain killers and finally delivered a healthy baby vaginally. Interestingly, during her parturition, she was tolerable with labor pain unlike her chronic pain that came from CES and CRPS.
Conclusion:
She is a unique and significant case because of the rare condition that has two pain-associated diseased and success of vaginal delivery without any complication during pregnancy. This case may be helpful in counselling attending physicians and may inspire other pre-existing CES or CRPS patients who are afraid to decide on pregnancy.
