title: Delayed quadriparesis after an interscalene brachial plexus block and general anesthesia: a differential diagnosis.
abstract: Interscalene brachial plexus block has been widely used for upper limb surgery. Different neurological complications related to this technique have been published. We report a case of quadriparesis of delayed onset, without loss of consciousness or cardiopulmonary compromise after an interscalene block and general anesthesia in a seated position. Postoperative quadriparesis, although infrequent, can occur through different causes and mechanisms. Central progression of an interscalene block can produce acute or subacute quadriparesis depending on technical factors of the placement of the local anesthetic and its subsequent spread. The symptomatology and the imaging enabled us to refine the differential diagnoses and to exclude other causes of neurologic compromise.
authors.affiliation: Department of Anesthesiology, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, Spain. pepearcas@hotmail.com
authors.forename: José Juan
authors.initials: JJ
authors.lastname: Arcas-Bellas
authors.forename: Fernando
authors.initials: F
authors.lastname: Cassinello
authors.forename: Beatriz
authors.initials: B
authors.lastname: Cercós
authors.forename: María
authors.initials: M
authors.lastname: del Valle
authors.forename: Vitorino
authors.initials: V
authors.lastname: Leal
authors.forename: Rafael
authors.initials: R
authors.lastname: Alvarez-Rementería
mesh_terms: D000368:Aged; D000768:Anesthesia, General; D001917:Brachial Plexus; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D009407:Nerve Block / Q000009:adverse effects*; D019637:Orthopedic Procedures; D011187:Posture; D011782:Quadriplegia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D020127:Recovery of Function; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013997:Time Factors