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J Clin Neurosci. 2015 Sep;22(9):1493-5. doi: 10.1016/j.jocn.2015.03.015. Epub 2015 May 16.

Transient monoplegia and paraesthesia after an epidural blood patch for a spinal cerebrospinal fluid leak.

Author information

1
Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong.
2
Department of Anesthesiology, Queen Mary Hospital, Pok Fu Lam, Hong Kong.
3
Division of Neurosurgery, Department of Surgery, Queen Mary Hospital, 102 Pok Fu Lam Road, Pok Fu Lam, Hong Kong. Electronic address: mattwmlui@netvigator.com.

Abstract

We describe the very rare complication of new onset complete paralysis and numbness of one limb after an epidural blood patch in a 36-year-old woman. Intracranial hypotension resulting from a spinal cerebrospinal fluid fistula may be treated by epidural injection of autologous blood that is, a blood patch. This is usually a safe and effective procedure. The woman's muscle strength of hip flexion, extension, ankle dorsiflexion and plantarflexion decreased from 5/5 to 0/5 following the procedure. After symptom onset, an MRI of her spine showed no compressive or ischaemic lesions amenable to urgent intervention. The cause of neurological deficit was at that time unknown and steroids were administered. Her symptoms persisted for about 2 days and gradually improved. In this paper, the management plan and the course of this rare and alarming complication is reported.

KEYWORDS:

Cerebrospinal fluid fistula; Epidural blood patch; Intracranial hypotension

PMID:
25986178
DOI:
10.1016/j.jocn.2015.03.015
[Indexed for MEDLINE]

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