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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Published on: November 8, 2024

[A case of unexpected involuntary movement of lower extremities during epidural anesthesia]

Hajime Takase1, Tetsuya Kushikata, Hironori Ishihara

  • 1Department of Anesthesiology, Hirosaki University School of Medicine, Hirosaki 036-8563.

Masui. the Japanese Journal of Anesthesiology
|November 24, 2004
PubMed

Insights

A patient experienced involuntary leg movements after epidural lidocaine injection for bladder tumor surgery. Further diagnostic imaging ruled out serious complications, though the exact cause remains unclear.

Area of Science:

  • Anesthesiology
  • Neurology

Background:

  • A 79-year-old male underwent transurethral resection of a bladder tumor.
  • Preoperative assessments showed no significant abnormalities.

Observation:

  • An epidural catheter was placed at the L3-4 interspace for anesthesia.
  • 1.5% lidocaine (10 ml) was administered without immediate adverse events.
  • Involuntary lower extremity movements began approximately 30 minutes post-injection.

Findings:

  • The involuntary movements persisted for 150 minutes without sensory or motor deficits.
  • Post-operative examination revealed no hemorrhage or pain at the puncture site.
  • Cerebral CT and lumbar MRI scans did not identify any abnormalities that could explain the movements.

Implications:

  • The precise mechanism of the observed involuntary movements remains undetermined.
  • Diagnostic imaging is crucial for excluding complications such as epidural hematoma.
  • This case highlights the importance of comprehensive evaluation for unexpected neurological events post-epidural anesthesia.

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