Park Kwang-Yeol, Kim Young Baeg
Department of Neurology , College of Medicine, Chung-Ang University, Seoul, Korea.
J Korean Neurosurg Soc. 2007 Dec;42(6):492-4. doi: 10.3340/jkns.2007.42.6.492. Epub 2007 Dec 20.
We present a case with seizure, confusion, hypesthesia and paraplegia after intrathecal injection of fluorescein. A 41-year-old man was admitted to our institution for the management of the CSF leakage. Intrathecal injection of fluorescein was performed and he complained of severe pain and numbness in the lower extremities at the end of the injection. Four hours later, he exhibited confusion, paraparesis and two episodes of generalized seizures. Two days later, he showed paraplegia and all sensory modalities below the T12 level were absent. Spine magnetic resonance imaging revealed myelopathic change in the lower thoracic spinal cord. There was no improvement of weakness and sensory deficits in lower extremity even 14 days after fluorescein injection. We speculated that thoracic myelopathy was associated with the intrathecal injection of fluorescein. In spite of its rarity, the complication after intrathecal injection of fluorescein could be serious. Thus, obtaining an informed consent with discussion with patient before the procedure is mandatory.
我们报告一例鞘内注射荧光素后出现癫痫发作、意识模糊、感觉减退和截瘫的病例。一名41岁男性因脑脊液漏入我院治疗。进行了鞘内注射荧光素,注射结束时他抱怨下肢剧痛和麻木。4小时后,他出现意识模糊、双下肢轻瘫和两次全身性癫痫发作。两天后,他出现截瘫,T12水平以下所有感觉模态均消失。脊柱磁共振成像显示下胸段脊髓有脊髓病变改变。即使在荧光素注射14天后,下肢的无力和感觉障碍也没有改善。我们推测胸段脊髓病与鞘内注射荧光素有关。尽管罕见,但鞘内注射荧光素后的并发症可能很严重。因此,在操作前与患者讨论并获得知情同意是必不可少的。