Horner's syndrome and trigeminal nerve palsy after lumbar epidural analgesia for labor and delivery.
This report highlights transient Horner's syndrome and trigeminal nerve palsy following labor epidural analgesia. A 29-year-old primigravida had a lumbar epidural catheter placed for analgesia in labor. The analgesia was maintained by infusion of a dilute local anesthetic/opioid mixture and turned off after achieving complete cervical dilation. Approximately 1 hour after delivery she complained of heaviness in her left eyelid, and was noted to have left-sided ptosis and paresthesia within the distribution of the ophthalmic and maxillary divisions of the trigeminal nerve, which resolved over the next 2 hours. There were no other neurologic changes. Horner's syndrome and cranial nerve palsies can occur as a consequence of epidural analgesia for labor.
Narouze
Samer N
SN
Division of Anesthesiology and Critical Care Medicine, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
Basali
Ayman
A
Mandel
Morris
M
Tetzlaff
John E
JE
D000328:Adult; D015360:Analgesia, Epidural / Q000009:adverse effects*; D016362:Analgesia, Obstetrical / Q000009:adverse effects*; D036861:Delivery, Obstetric; D005260:Female; D006732:Horner Syndrome / Q000209:etiology*; D006801:Humans; D007743:Labor, Obstetric / Q000502:physiology*; D008161:Lumbosacral Region / Q000294:innervation; D015840:Oculomotor Nerve Diseases / Q000209:etiology*; D011247:Pregnancy; D020433:Trigeminal Nerve Diseases / Q000209:etiology*