The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
권호 표지

Paraplegia following Epidural Steroid Injection -A case report-

경막외 스테르이드 주입후 발생한 하지마비 -증례 보고-

  • Chung, So-Young (Department of Anesthesiology, Yonsei University College of Medicine) ;
  • Song, Jang-Ho (Department of Anesthesiology, Inha University College of Medicine) ;
  • Lee, Mi-Ra (Department of Anesthesiology, Inha University College of Medicine) ;
  • Lee, Hong-Sik (Department of Anesthesiology, Inha University College of Medicine) ;
  • Park, Dong-Ho (Department of Anesthesiology, Inha University College of Medicine)
  • 정소영 (연세대학교 의과대학 마취과학교실) ;
  • 송장호 (인하대학교 의과대학 마취과학교실) ;
  • 이미라 (인하대학교 의과대학 마취과학교실) ;
  • 이홍식 (인하대학교 의과대학 마취과학교실) ;
  • 박동호 (인하대학교 의과대학 마취과학교실)
  • Published : 1994.05.30
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Abstract

This report documents a case of paraplegia which apparently occurred following epidural injection of triamcinolone (40 mg) and 0.125% bupivacaine(10 ml). The patient's condition was progressive until she experienced paraplegia and dissociative sensory loss below T5(Rt) and T10(Lt) dernatomes, along with urinary and fecal incontinence lasting 24 hours. CT and MRI were normal. Three months after the onset of paraplegia, the patient could only slightly move her legs. After 8 months of the initial paraplegia, she was able to walk with assistance, and to perceive pinrick sensation in her right leg, and tingling in her left leg. She could also void and defecate. At 16 months, paraplegia and sensory loss were slightly recovered. The cause for this paraplegia is still unknown, but it may be from exacerbation of preexisting disease, acute transverse myelitis, anterior spinal artery syndrome, or neurotoxicity.

45세 여자 환자에서 요하지통의 치료를 위해 triamcinolone 40 mg과 0.125% bupivacaine 10 ml를 경막외로 주입한후 24시간에 걸쳐 하지마비 및 해리성 감각소설이 발생하였다. 그 원인은 분명하지 않으나 선행절환의 악화, 급성 횡단성 척수염, 전척수동맥증후군, 그리고 신경독성등이 추정된다.

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