Abducens palsy after an intrathecal glucocorticoid injection. Evidence for a role of intracranial hypotension.
We report a case of abducens palsy eight days after an intrathecal glucocorticoid injection followed by post-lumbar puncture syndrome. T1-weighted magnetic resonance imaging scans showed marked diffuse postgadolinium enhancement of the supra- and infratentorial meninges consistent with intracranial hypotension syndrome. The palsy resolved almost completely and a repeat magnetic resonance imaging scan done after four months was normal. The mechanism of the meningeal thickening and contrast enhancement is discussed.
Dumont
D
D
Rheumatology Department, Avicenne Teaching Hospital, Bobigny, France.
Hariz
H
H
Meynieu
P
P
Salama
J
J
Dreyfus
P
P
Boissier
M C
MC
D020222:Abducens Nerve Injury; D000328:Adult; D003389:Cranial Nerve Diseases / Q000175:diagnosis / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D007278:Injections, Spinal / Q000009:adverse effects*; D017116:Low Back Pain / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D010243:Paralysis / Q000175:diagnosis / Q000209:etiology*; D011239:Prednisolone / Q000008:administration & dosage*; D012075:Remission, Spontaneous; D014950:Wounds, Penetrating / Q000209:etiology*
D005938:Glucocorticoids; D011239:Prednisolone