Acute Transverse Myelitis After Spinal Anesthesia: Should Anesthesia Be Condemned?
Abstract
Richmond R Gomes
Spinal anesthesia is widely used during surgical procedures. It is generally safe and the frequency of severe, perma- nent neurological complications associated with it has been reported to be extremely low. We report a patient, who developed paraplegia following spinal anesthesia. A 23-year-old lady developed acute transverse myelitis (ATM) with a rapid progression of acute motor sensory spastic paraplegia and autonomic dysfunction 24 hours after deliv- ery of her first child by caesarean section. Spinal magnetic resonance imaging revealed myelitis at D9-12. She was given 1-gram methyl prednisolone daily for 5 days followed by oral prednisolone 1mg/kg/day which was tapered off in next 3 months. The neurological recovery was fairly good and the patient returned to full time work in 6 months. Since spinal anesthesia had been used in our case, a causal relationship can be assumed. This case emphasizes the danger of attributing all cases of transverse myelitis which have a close temporal relationship to spinal or epidural anesthesia, to the anesthetic technique itself.