title: Paraplegia following coeliac plexus block.
abstract: Coeliac plexus block (CPB) is one of the few neurolytic procedures that is still considered very useful in managing chronic cancer pain. We describe what we believe to be the fifth case in the literature of paraplegia following coeliac plexus block with ethyl alcohol. Clinical and neurophysiological examination confirmed the hypothesis of an acute myelopathy probably caused by ischemia due to involvement of Adamkievicz's artery. The seriousness of this neurological complication led us to review the different pain-relieving strategies in pancreatic cancer. Several medical and surgical procedures are available for advanced pancreatic cancer, yet none of them alone can be considered the therapy of choice for all cases. Hence, only a multidisciplinary approach to pancreatic cancer pain can help in making the most appropriate choice for each patient.
authors.affiliation: Pain Therapy and Palliative Care Division National Cancer Institute, MilanItaly Departments of Clinical Surgery, University of Milan, Scientific Institute, San Raffaele Hospital, MilanItaly Departments of Clinical Neurology IV, University of Milan, Scientific Institute, San Raffaele Hospital, MilanItaly.
authors.forename: Franco
authors.initials: F
authors.lastname: De Conno
authors.forename: Augusto
authors.initials: A
authors.lastname: Caraceni
authors.forename: Luca
authors.initials: L
authors.lastname: Aldrighetti
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Magnani
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Ferla
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Comi
authors.forename: Vittorio
authors.initials: V
authors.lastname: Ventafridda
mesh_terms: D000230:Adenocarcinoma / Q000150:complications; D000368:Aged; D002447:Celiac Plexus; D000431:Ethanol; D005073:Evoked Potentials, Somatosensory; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009407:Nerve Block / Q000009:adverse effects*; D010148:Intractable Pain / Q000209:etiology / Q000628:therapy; D010190:Pancreatic Neoplasms / Q000150:complications; D010264:Paraplegia / Q000209:etiology* / Q000503:physiopathology
chemical_list: D000431:Ethanol