title: Exacerbation of preexisting neurological deficits by neuraxial anesthesia: report of 7 cases.
abstract: We undertook this case series to determine if preexisting neurological disease is exacerbated by either spinal or epidural anesthesia. In the website of the Arachnoiditis Foundation, we posted an offer to advise anesthesiologists in cases of neurological problems after either of these techniques was used. Contacts were made first by way of the Internet, confirmed by telephone, and maintained by fax, e-mail, or by special mail. Patients here described were cared for and observed by one of the authors, in a hospital, in Argentina or in Mexico. A total of 7 adult, ASA physical status I and II patients, including 3 men and 4 women, with subtle symptoms of neurological disease before anesthesia, are described. Two patients had continuous lumbar epidural anesthesia, 3 had spinals; in 2 more, attempted epidural blocks led to accidental dural puncture and were converted to subarachnoid anesthetics. All patients accepted neuraxial anesthesia without informing the anesthesiologists that they had mild neurological symptoms before surgery. Because anesthesiologists did not specifically inquire about subclinical neurological symptoms or prior neurological disease, anesthesiologists are advised to carefully inquire about prior neurological disease whether neuraxial anesthesia techniques are considered.
authors.affiliation: Arachnoiditis Clinic, The Arachnoiditis Foundation, Inc, Birmingham, AL 35243, USA. aldrete@arachnoiditis.com
authors.forename: J Antonio
authors.initials: JA
authors.lastname: Aldrete
authors.forename: Marisela
authors.initials: M
authors.lastname: Reza-Medina
authors.forename: Olga
authors.initials: O
authors.lastname: Daud
authors.forename: Silvia
authors.initials: S
authors.lastname: Lalin-Iglesias
authors.forename: Gustavo
authors.initials: G
authors.lastname: Chiodetti
authors.forename: Uriah
authors.initials: U
authors.lastname: Guevara
authors.forename: Jaime A
authors.initials: JA
authors.lastname: Wikinski
authors.forename: Alberto
authors.initials: A
authors.lastname: Torrieri
mesh_terms: D000328:Adult; D000767:Anesthesia, Epidural / Q000009:adverse effects*; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications*