Acute Crit Care.  2024 Aug;39(3):441-443. 10.4266/acc.2021.01697.

Abducens paralysis—a rare complication of spinal anesthesia at an emergency department: a case report

Affiliations
  • 1Department of Emergency Medicine, Health Science University Antalya Training and Research Hospital, Antalya, Türkiye

Abstract

The sixth cranial nerve (CN VI) is a rare site of complication associated with spinal anesthesia and can produce secondary symptoms of ocular muscle palsy. A 38-year-old man was admitted to the emergency department with complaint of diplopia and limited lateral gaze in the first week after endoscopic urological surgery under spinal anesthesia. Isolated unilateral CN VI palsy was considered after excluding differential diagnoses. Ocular palsy and diplopia regressed with conservative treatment during follow-up, and the patient was discharged. This article aims to show that CN VI palsy is a rare complication of spinal anesthesia, which can be observed in the emergency department.

Keyword

emergency department; sixth cranial nerve palsy; spinal anesthesia

Reference

1. Sotoodehnia M, Safaei A, Rasooli F, Bahreini M. Unilateral sixth nerve palsy. Am J Emerg Med. 2017; 35:934.e1–934.e2.
2. Saraçoglu A, Saraçoglu KT, Çakir M, Çakir Z. Abducens nerve paralysis following spinal anesthesia. Turk J Anaesthesiol Reanim. 2013; 41:24.
3. Hayman IR, Wood PM. Abduceus nerve (VI) paralysis following spinal anesthesia. Ann Surg. 1942; 115:864–8.
4. Shewakramani S, McCann DJ, Thomas SH, Nadel ES, Brown DF. Sixth cranial nerve palsy. J Emerg Med. 2005; 29:207–11.
5. Hofer JE, Scavone BM. Cranial nerve VI palsy after dural-arachnoid puncture. Anesth Analg. 2015; 120:644–6.
6. Lopez-Soriano F, Rivas-Lopez FA. VIth cranial nerve paresis after spinal anesthesia. Int J Anesthesiol. 2002; 5:4.
7. İnce M, İnce L, Özbek S. Spinal anestezi sonrasında abdusens sinir paralizisi: olgu sunumu. Gülhane Tıp Derg. 2012; 54:175–7.
8. Kim YA, Yoon DM, Yoon KB. Epidural blood patch for the treatment of abducens nerve palsy due to spontaneous intracranial hypotension: a case report. Korean J Pain. 2012; 25:112–5.
9. Béchard P, Perron G, Larochelle D, Lacroix M, Labourdette A, Dolbec P. Case report: epidural blood patch in the treatment of abducens palsy after a dural puncture. Can J Anaesth. 2007; 54:146–50.
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