Korean J Anesthesiol.  2010 Dec;59(Suppl):S222-S225. 10.4097/kjae.2010.59.S.S222.

Transient cauda equina syndrome related to a sacral schwannoma with cauda equine compression after a lumbar epidural block: A case report

• Kim HT
• Gim TJ
• Lee JH

• KMID: 2237392
• DOI: http://doi.org/10.4097/kjae.2010.59.S.S222

Abstract

A 53-year-old man had chronic low back and leg pain for four years without any history of trauma or neurological manifestations. There was a reduction in symptoms after a lumbar epidural block. Two hours later after the procedure, the patient complained of perineal numbness and lower extremity weakness. The neurological evaluation revealed loss of sensation in the saddle area and the posterior aspect of the leg. The deep-tendon reflexes were decreased in the leg. The patient was unable to urinate. The MRI revealed a schwannoma at the S3 level of the sacral spine with cauda equina compression. The patient's symptoms improved slightly over the next few hours. The patient had a gradual return of motor function and could feel the Foley catheter. All of the symptoms completely resolved over the next nine hours and the patient was discharged to home once completely recovered. This case illustrates the importance of clinical examination and continued vigilance for evaluation of neurological deterioration after epidural injections.

Keyword

Cauda equina syndrome; Low back pain; Schwannoma

MeSH Terms

Catheters
Cauda Equina
Humans
Hypesthesia
Injections, Epidural
Leg
Low Back Pain
Lower Extremity
Middle Aged
Neurilemmoma
Neurologic Manifestations
Polyradiculopathy
Reflex
Sensation
Spine