Korean J Anesthesiol.  2008 Sep;55(3):391-394. 10.4097/kjae.2008.55.3.391.

Propriospinal myoclonus after cervical epidural blockade: A case report

• Ryu HK
• Lee SG
• Min BW
• Ban JS
• Lee JH
• Kim EJ

• KMID: 1764036
• DOI: http://doi.org/10.4097/kjae.2008.55.3.391

Abstract

Myoclonus is one of the rare complications after the neuroaxial blockade. We report a patient who developed propriospinal myoclonus following cervical epidural steroid injection. An outpatient, 73-years-old man, complaining of a tingling sensation from the right shoulder of supraspinatous region to the ipsilateral hand, particularly along the C6 dermatome, visited our pain clinic center. In cervical magnetic resonance imaging scan, the disc between 6th and 7th cervical vertebrae was herniated and pressed the nerves to the right side. We performed cervical epidural steroid injection, using triamcinolone acetonide 40 mg with 0.25% bupivacaine HCL 5 ml. After the first injection, he had no problem, but following the second injection, myoclonic movements were developed and lasted for 6 hours along only the right side of the whole body without other neurologic complications. The myoclonic movement improved by intravenous injection of clonazepam 0.5 mg and the patient completely recovered without any neurologic sequelae on that day.

Keyword

bupivacaine; cervical epidural block; propriospinal myoclonus

MeSH Terms

Bupivacaine
Cervical Vertebrae
Clonazepam
Female
Hand
Humans
Injections, Intravenous
Magnetic Resonance Imaging
Myoclonus
Outpatients
Pain Clinics
Sensation
Shoulder
Triamcinolone Acetonide
Bupivacaine
Clonazepam
Triamcinolone Acetonide