Severe flaccid paraparesis following spinal anaesthesia: a sine materia occurrence.
We report the case of a 45-year-old female patient who underwent spinal anaesthesia for a minor urological intervention, trying to correct her stress urinary incontinence. Hyperbaric bupivacaine was intrathecally injected and the surgical intervention ended uneventfully. Six hours after the operation a severe motor deficit of lower limbs was noted. The situation persisted and neurologists repeatedly checked on the patient; imaging of the lumbar spine was made but no pathological signal was registered. Somatosensory evoked potentials of the lower limbs showed bilaterally delayed latencies of the cortical components, with prolonging of interpeak latencies, suggestive of a suffering of the long somatosensory spinal tracts. Unable initially to walk or stand in erect position with almost no movements in both lower limbs, the patient was admitted in a rehabilitation facility and treated there for 4 months, with her condition substantially improving during this period.
Department of Biomedical and Experimental, Faculty of Medicine, Tirana, Albania.
Gentian
G
Vyshka
University of Sannio, Benevento, Italy.
Giuseppe
G
Vacchiano
D000775:Anesthesia, Spinal / Q000009:adverse effects* / Q000379:methods; D002045:Bupivacaine / Q000008:administration & dosage / Q000009:adverse effects; D005073:Evoked Potentials, Somatosensory; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009416:Nerve Regeneration / Q000502:physiology; D020335:Paraparesis / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation*; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014550:Urinary Incontinence, Stress / Q000601:surgery; D013520:Urologic Surgical Procedures / Q000009:adverse effects / Q000379:methods
D002045:Bupivacaine