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一例鞘内注射荧光素后发生脊髓病的病例。

A case of myelopathy after intrathecal injection of fluorescein.

作者信息

Park Kwang-Yeol, Kim Young Baeg

机构信息

Department of Neurology , College of Medicine, Chung-Ang University, Seoul, Korea.

出版信息

J Korean Neurosurg Soc. 2007 Dec;42(6):492-4. doi: 10.3340/jkns.2007.42.6.492. Epub 2007 Dec 20.

Abstract

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.

摘要

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。

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本文引用的文献

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Safety of low-dose intrathecal fluorescein in endoscopic cranial base surgery.
Neurosurgery. 2007 Sep;61(3 Suppl):161-5; discussion 165-6. doi: 10.1227/01.neu.0000289729.20083.dc.
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Intrathecal fluorescein in endoscopic skull base surgery.
Otolaryngol Head Neck Surg. 2007 Aug;137(2):316-20. doi: 10.1016/j.otohns.2006.11.012.
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Delayed absence seizure: a complication of intrathecal fluorescein injection. A case report and literature review.
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Endoscopic endonasal approaches for repair of cerebrospinal fluid leaks: nine-year experience.鼻内镜下经鼻入路修复脑脊液漏:九年经验
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