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KMID : 0390320190290010047
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Chungbuk Medical Journal
2019 Volume.29 No. 1 p.47 ~ p.53
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Psychogenic paresis following spinal anesthesia: A case report
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Kim Gunn-Hee
Kim Go-Eun
Song Young-Dong
Son Shill-Lee
Kwon Mi-Young
Koo Min-Seok
Kim Sang-Tae
Shin Young-Duck
Kim In-Tae
Lee Joo-Yong
Yun Mi-Jung
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Abstract
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A 52-year-old woman presented with motor and sensory deficits in her left leg, after undergoing spinal anesthesia for arthroscopic left knee surgery. Her complex medical history included anxiety disorder, depression, post-traumatic syndrome, somatization disorder, chronic migraine, and repeated left knee operations. She underwent spinal anesthesia and achieved adequate surgical sensory and motor blockade (T8). The arthroscopic operation was uneventful. That evening, she reported non-recovery in the motor and sensory capacities in her left leg. Emergent brain and spine magnetic resonance imaging did not reveal hematoma. The paralysis did not follow anatomical patterns, and was inconsistent upon repeated examination. A neurologist diagnosed it as psychogenic paresis, a type of conversion disorder. Postoperative leg paresis recovered over a 4-month period of multidisciplinary treatment. Psychogenic paresis is not commonly reported, particularly following neuraxial anesthesia. The risk factors, neurological symptoms and signs identified in the present case of psychogenic paresis were reviewed.
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KEYWORD
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Anesthesia, Spinal, Conversion disorder, Paresis, Surgery, Knee
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