J Korean Pain Soc.  2004 Jun;17(1):75-78. 10.3344/jkps.2004.17.1.75.

Paralysis after Caudal Epidural Block for Radiculopathic Patients: A case report

Affiliations
  • 1Department of Anesthesiology and Pain Medicine, College of Medicine, Chungnam National University, Daejeon, Korea. whlee@cnu.ac.kr

Abstract

Caudal epidural block has been introduced as an effective management for the treatment of pain with radiculopathy. Although it is very rare, ominous neurologic symptoms after caudal epidural block may occur. A 33-year-old woman complained of low back pain radiating to the lateral side of her left foot. A few minutes later after caudal epidural block, she complained of general lower limb weakness, dizziness, and dyspnea. Emergency thoracic and lumbar magnetic resonance imaging showed no remarkable finding except for left L4-5 disc bulging. Her neurologic condition showed a slow improvement over 10 days and she complained of anxiety and anorexia. On the eleventh hospital day, she was referred to the psychiatry department to rule out a psychosomatic disorder. She was diagnosed with anxiety disorder, not otherwise specified. Immediate treatment with alprazolam (Xanax(R)) 0.5 mg and paroxetine (Parox(R)) 10 mg and rehabilitational supportive therapy was started and the patient was subsequently discharged without neurologic sequelae.

Keyword

caudal epidural block; paralysis; radiculopathy

MeSH Terms

Adult
Alprazolam
Anorexia
Anxiety
Anxiety Disorders
Dizziness
Dyspnea
Emergencies
Female
Foot
Humans
Low Back Pain
Lower Extremity
Magnetic Resonance Imaging
Neurologic Manifestations
Paralysis*
Paroxetine
Psychophysiologic Disorders
Radiculopathy
Alprazolam
Paroxetine
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