[Motor deficit of the lower limbs and urinary incontinence following peridural anesthesia].
Neurological complications of epidural anaesthesia are rare, but can be severe. We report the case of a 49-year-old man, with a history of non equilibrated diabetes, who experienced after an epidural anaesthesia for peripheral vascular surgery a polyneuropathy with muscle weakness of the lower extremities associated with a transient urinary incontinence. A spinal compression was excluded by computed tomography and magnetic resonance imaging. Electromyography showed an impaired nervous motor conduction. An aggravation of a pre-existing diabetic and alcoholic polyneuropathy, associated with possible spinal ischaemia of multifactorial origin could be the cause of these complications. This case emphasizes the importance, during preanesthetic assessment of candidates for epidural or spinal anaesthesia, to search for a possible unrecognized neuropathy at risk of aggravation by regional anaesthesia.
Lena
P
P
Cardiologie médicochirurgicale, Institut Arnault-Tzanck, Saint-Laurent-du-Var, France.
Teboul
J
J
Mercier
B
B
Bonnet
F
F
D000437:Alcoholism / Q000150:complications; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D048909:Diabetes Complications; D003929:Diabetic Neuropathies / Q000150:complications; D004576:Electromyography; D006801:Humans; D007511:Ischemia / Q000209:etiology; D007866:Leg / Q000098:blood supply / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009046:Motor Neurons / Q000502:physiology; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology*; D009431:Neural Conduction / Q000187:drug effects; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D016491:Peripheral Vascular Diseases / Q000601:surgery; D013117:Spinal Cord Compression / Q000175:diagnosis; D013131:Spine / Q000098:blood supply; D014057:Tomography, X-Ray Computed; D014549:Urinary Incontinence / Q000209:etiology*
Déficit moteur des membres inférieurs et incontinence urinaire au décours d'une anesthésie péridurale.