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Transient paraplegia following alcohol celiac plexus block
1Department of Anesthesiology, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA.
Regional Anesthesia
|July 1, 1995
Summary
Alcohol celiac plexus neurolysis for pancreatic cancer pain can cause temporary spinal cord ischemia, leading to transient paraplegia. This rare complication may result from ethanol-induced arterial spasm.
Area of Science:
- Neurology
- Oncology
- Pain Management
Background:
- Pancreatic cancer frequently causes severe pain, necessitating advanced pain management strategies.
- Celiac plexus neurolysis is an established procedure for managing cancer-related abdominal pain.
Observation:
- A patient with metastatic pancreatic cancer developed transient paraplegia after alcohol celiac plexus neurolysis.
- The paraplegia was consistent with anterior spinal artery syndrome, indicating spinal cord ischemia.
Findings:
- Clinical findings indicated anterior spinal cord ischemia with complete motor and sensory paralysis up to the T8 spinal cord level.
- The event occurred despite seemingly adequate needle placement during the neurolysis procedure.
Implications:
- This case highlights a rare but serious complication of celiac plexus neurolysis.
- Reversible arterial spasm following ethanol injection is a potential mechanism for spinal cord ischemia in this context.