A chinese male aged 46 years presented with right side radial nerve damage following general anesthesia for left cataract operation was presented. Budinger in 1894 was first to recognize that the majority of postoperative neuropathies was due to malpositioning of the patient upon the operating table, with consequent stretching and compression of nerves. His findings were soon verified by many reporters.
But in the presenting case, I believe that there was no compression, or stretching of the radial nerve, hypoxia, hypotension accidental limb movement were noted during anesthesia or in the post-operative period.
X-ray of the cervical spine did not reveal any abnormalities and there was no history of trauma of the cervical spine, or shoulder, and upper limbs and there was no infection or tumor in the elbow region.
In this case, it is suggested that a mild diabetic mononeuropathy progressed to a diabetic mononeuropathic paralysis after anesthesia, because this case had a past history of5 years diabetes mellitus.
Diabetic neuropathy is a well recognized condition, the stated incidence of which has varied from 0.5% of diabetic to 50%. It is suggested in the absence of any causative factors otherthan diabetes mellitus, that this condition must be considered a primary factor in the production of this neurological lesion.
|