Article

This report describes a case of cauda equina syndrome possibly caused by
arachnoiditis due to levobupivacaine after spinal-epidural anesthesia. A
39-yr-old woman delivered by cesarean section under a combined spinal-epidural
anesthesia. After an uneventful procedure and surgery, she complained of weakness
in her lower extremities, which increased in a few hours. Neurologic examination
revealed severe weakness in both her lower extremities, perianal anesthesia, and
absence of muscle stretch reflexes. She was unable to urinate. Magnetic resonance
imaging performed immediately revealed entirely normal results; however,
gadolinium-enhanced magnetic resonance imaging 10 days later revealed contrast
enhancement in the cauda equina fibers concordant with arachnoiditis. The patient
was included in an intense rehabilitation program with a diagnosis of cauda
equina syndrome and recovered completely in 8 wks. Practitioners should be aware
of neurologic complications of spinal-epidural anesthesia. Early detection and
treatment of the complication are important to minimize the risk of adverse
outcome.

Langue : ANGLAIS