Ann Rehabil Med.  2013 Jun;37(3):453-458. 10.5535/arm.2013.37.3.453.

Flaccid Leg Paralysis Caused by a Thoracic Epidural Catheterization: A Case Report

• Jeon BH
• Bang HJ
• Lee GM
• Kwon OP
• Ki YJ

• KMID: 2219547
• DOI: http://doi.org/10.5535/arm.2013.37.3.453

Abstract

We report a case of a 44-year-old patient with paralysis of the left leg who had a thoracic epidural catheterization after general anesthesia for abdominal surgery. Sensory losses below T10 and motor weakness of the left leg occurred after the surgery. Magnetic resonance image study demonstrated a well-defined intramedullary linear high signal intensity lesion on T2-weighted image and low-signal intensity on T1-weighted image in the spinal cord between T9 and L1 vertebral level, and enhancements of the spinal cord below T8 vertebra and in the cauda equina. Electrodiagnostic examination revealed lumbosacral polyradiculopathy affecting nerve roots below L4 level on left side. We suggest that the intrinsic spinal cord lesion and nerve root lesion can be caused by an epidural catheterization with subsequent local anesthetic injection.

Keyword

Spinal cord injuries; Epidural analgesia; Paralysis

MeSH Terms

Analgesia, Epidural
Anesthesia, General
Catheterization
Catheters
Cauda Equina
Humans
Leg
Magnetic Resonance Spectroscopy
Paralysis
Polyradiculopathy
Spinal Cord
Spinal Cord Injuries
Spine

Figure

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  Fig. 1 Magnetic resonance T2-weighted imaging of the thoracolumbar spine. Sagittal T2-weighted image (A) and axial T2-weighted image (B) reveal well-defined intramedullary linear high signal intensity (arrow) on the left side between T9 and L1 vertebral level of spinal cord.

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  Fig. 2 Magnetic resonance T1-enhanced imaging of thoracolumbar spine. Sagittal T1-enhanced image (A) and axial T1-enhanced image (B) show enhancement (arrow) in the spinal cord between T9 and L1 vertebral level, and diffuse enhancement of the spinal cord below T12 vertebral level and in the cauda equine.

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