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

Ann Rehabil Med. 2013 Jun;37(3):453-8. doi: 10.5535/arm.2013.37.3.453. Epub 2013 Jun 30.

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.

Keywords: Epidural analgesia; Paralysis; Spinal cord injuries.