The Korean Journal of Pain

The Korean Pain Society (대한통증학회)
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Unilateral Horner's Syndrome and Upper Extremity Paralysis following Lumbar Epidural Block in a Obstetric Patient

산모에서 요부 경막외 차단후 발생한 편측 호너 증후군과 상지마비 -증례 보고-

  • Jang, Yeon (Department of Anesthesiology, Catholic University Collage of Medicine) ;
  • Cho, Eun-Chung (Department of Anesthesiology, Catholic University Collage of Medicine) ;
  • Kim, Jung-Tae (Department of Anesthesiology, Catholic University Collage of Medicine) ;
  • Park, Soo-Seog (Department of Anesthesiology, Catholic University Collage of Medicine) ;
  • Lee, Jae-Hee (Department of Radiology, Catholic University Collage of Medicine)
  • 장연 (가톨릭대학교 의과대학 마취과학교실) ;
  • 조은정 (가톨릭대학교 의과대학 마취과학교실) ;
  • 김정태 (가톨릭대학교 의과대학 마취과학교실) ;
  • 박수석 (가톨릭대학교 의과대학 마취과학교실) ;
  • 이재희 (가톨릭대학교 의과대학 방사선과학교실)
  • Published : 1997.11.22
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Abstract

Horner's syndrome is a well-recognized complication of regional analgesia of neck and shoulder region, and not often a complication of lumbar or low thoracic epidural block. Recently we experienced right Horner's syndrome accompanying paralysis of right upper extremity following lumbar epidural block in for an obstetric patient. Epidurography and MRI was performed to clarify the cause of unilateral high epidural block and cervical sympathetic block. Radiologic study demonstrated a loop formation of the epidural catheter and tip of catheter was located in right anterior epidural spaced(L1-2). The initial epidurogram revealed unilateral spreading of dye in the cervical region in right epidural space. A second epidurogram, 10 minutes following, showed dye filling in left epidural space, however spread of dye in left side was limited to lumbar and low thoracic region. We concluded the most probable cause of this unilateral high epidural block was due to misplacement of the catheter into the anterior epidural space.

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