J Korean Pain Soc.  1997 Nov;10(2):285-290.

Unilateral Homer's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient

• Jang Y
• Cho EC
• Kim JT
• Park SS
• Lee JH

Abstract

Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidurnl space (L1-2). The initial epidutogram revealed unilateral spteading of dye in the cervical region in right epidural space, A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural Space.

Keyword

Anesthetic technique, epidural; Horner's syndrome, unilateral

MeSH Terms

Analgesia
Catheters
Epidural Space
Horner Syndrome
Humans
Magnetic Resonance Imaging
Neck
Paralysis*
Shoulder
Upper Extremity*