Korean J Anesthesiol.  2008 Oct;55(4):523-525. 10.4097/kjae.2008.55.4.523.

A case of spinal myoclonus with radiculopathy following spine surgery: A case report

• Lee JY
• Chung KJ
• Chung MH
• Choi YR
• Won RS
• Kim YJ

• KMID: 2237421
• DOI: http://doi.org/10.4097/kjae.2008.55.4.523

Abstract

Despite adequate surgery, a number of patients have a return of back pain and radiculopathy of the legs following their operation. We present here a case of spinal myoclonus with radiculopathy after spine surgery. A 51 year old woman with bilateral radiculopathy and urinary incontinence was diagnosed with a cauda equina syndrome along with spinal stenosis. The patient underwent emergency operation for posterior decompression and internal fixation from the L2 to S1 levels. Immediately after surgery, the patient continued to experience intermittent myoclonic movement with severe shooting pain in her legs despite being given pharmacological treatments such as benzodiazepines, opioids, NSAIDs and gabapentin. The patient was found to have sudden, brief, bilateral involuntary muscle contraction on the lower extremities. The patient was referred to our pain clinic. She underwent a caudal block 2 times in 4 days. However, she reported only limited pain relief for 3 to 4 hours. She was then prescribed phenytoin 300 mg intravenously in a day; her myoclonic movement gradually subsided after 1 week of receiving phenytoin. Sixty days later, she was discharged without any long term sequelae.

Keyword

myoclonus; radiculopathy; spinal surgery

MeSH Terms

Amines
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Back Pain
Benzodiazepines
Contracts
Cyclohexanecarboxylic Acids
Decompression
Emergencies
Female
gamma-Aminobutyric Acid
Humans
Leg
Lower Extremity
Muscle, Smooth
Myoclonus
Pain Clinics
Phenytoin
Polyradiculopathy
Radiculopathy
Spinal Stenosis
Spine
Urinary Incontinence
Amines
Analgesics, Opioid
Anti-Inflammatory Agents, Non-Steroidal
Benzodiazepines
Cyclohexanecarboxylic Acids
Phenytoin
gamma-Aminobutyric Acid