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CASE REPORT
Year : 2011  |  Volume : 55  |  Issue : 4  |  Page : 375-377

Cauda equina syndrome after spinal anaesthesia in a patient with asymptomatic tubercular arachnoiditis


Department of Anaesthesia and Intensive Care, Employees' State Insurance Postgraduate Institute of Medical Sciences and Research (ESIC PGIMSR), Basaidarapur, New Delhi, India

Correspondence Address:
Divya Sethi
A-2B/118-B, Paschim Vihar, New Delhi - 110 063
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0019-5049.84864

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A 14-year-old boy underwent emergency debridement surgery of right foot under spinal anaesthesia. Four hours after the surgery, the patient developed symptoms of cauda equina syndrome (CES). Postoperative magnetic resonance imaging of the patient's spine suggested underlying tubercular arachnoiditis. The boy was started on intravenous methylprednisolone and antitubercular therapy. He responded to the therapy and recovered completely in 2 weeks without any residual neurological deficits. We suggest that underlying pathological changes in the subarachnoid space due to tubercular arachnoiditis contributed to maldistribution of the local anaesthetic drug leading to CES.


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