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Flaccid leg paralysis caused by a thoracic epidural catheterization: a case report.

Jeon BH, Bang HJ, Lee GM, Kwon OP, Ki YJ - Ann Rehabil Med (2013)

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

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.

No MeSH data available.


Related in: MedlinePlus

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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Figure 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.

Mentions: On the 9th postoperative day, the magnetic resonance imaging (MRI) of thoracolumbar spine was performed. It revealed well-defined intramedullary linear high-signal-intensity lesion at the sagittal T2-weighted images and low-signal-intensity lesion at the T1-weighted images, in the left spinal cord between T9 and the L1 vertebral level. Also, the T1-enhanced images showed minimal enhancements in the spinal cord between T9 and the L1 vertebral level, and diffuse enhancements in the spinal cord below the T12 vertebral level and in the cauda equina (Figs. 1, 2).


Flaccid leg paralysis caused by a thoracic epidural catheterization: a case report.

Jeon BH, Bang HJ, Lee GM, Kwon OP, Ki YJ - Ann Rehabil Med (2013)

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3713307&req=5

Figure 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.
Mentions: On the 9th postoperative day, the magnetic resonance imaging (MRI) of thoracolumbar spine was performed. It revealed well-defined intramedullary linear high-signal-intensity lesion at the sagittal T2-weighted images and low-signal-intensity lesion at the T1-weighted images, in the left spinal cord between T9 and the L1 vertebral level. Also, the T1-enhanced images showed minimal enhancements in the spinal cord between T9 and the L1 vertebral level, and diffuse enhancements in the spinal cord below the T12 vertebral level and in the cauda equina (Figs. 1, 2).

Bottom Line: 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.

View Article: PubMed Central - PubMed

Affiliation: Department of Rehabilitation Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

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.

No MeSH data available.


Related in: MedlinePlus