Unilateral Hemiparesis with Thoracic Epidural in an Adolescent
Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated comp...
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| Format: | Article |
| Language: | English |
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Wiley
2012-01-01
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| Series: | Case Reports in Anesthesiology |
| Online Access: | http://dx.doi.org/10.1155/2012/732584 |
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| author | Rosalie F. Tassone Christian Seefelder Navil F. Sethna |
| author_facet | Rosalie F. Tassone Christian Seefelder Navil F. Sethna |
| author_sort | Rosalie F. Tassone |
| collection | DOAJ |
| description | Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner’s syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade. |
| format | Article |
| id | doaj-art-850cc107673c4a0fa128ddf0d4502012 |
| institution | Kabale University |
| issn | 2090-6382 2090-6390 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Anesthesiology |
| spelling | doaj-art-850cc107673c4a0fa128ddf0d45020122025-02-03T01:23:59ZengWileyCase Reports in Anesthesiology2090-63822090-63902012-01-01201210.1155/2012/732584732584Unilateral Hemiparesis with Thoracic Epidural in an AdolescentRosalie F. Tassone0Christian Seefelder1Navil F. Sethna2Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USADepartment of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USADepartment of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USAObjective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner’s syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade.http://dx.doi.org/10.1155/2012/732584 |
| spellingShingle | Rosalie F. Tassone Christian Seefelder Navil F. Sethna Unilateral Hemiparesis with Thoracic Epidural in an Adolescent Case Reports in Anesthesiology |
| title | Unilateral Hemiparesis with Thoracic Epidural in an Adolescent |
| title_full | Unilateral Hemiparesis with Thoracic Epidural in an Adolescent |
| title_fullStr | Unilateral Hemiparesis with Thoracic Epidural in an Adolescent |
| title_full_unstemmed | Unilateral Hemiparesis with Thoracic Epidural in an Adolescent |
| title_short | Unilateral Hemiparesis with Thoracic Epidural in an Adolescent |
| title_sort | unilateral hemiparesis with thoracic epidural in an adolescent |
| url | http://dx.doi.org/10.1155/2012/732584 |
| work_keys_str_mv | AT rosalieftassone unilateralhemiparesiswiththoracicepiduralinanadolescent AT christianseefelder unilateralhemiparesiswiththoracicepiduralinanadolescent AT navilfsethna unilateralhemiparesiswiththoracicepiduralinanadolescent |