From the Department of Anesthesiology and Perioperative Medicine.
Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama.
A A Pract. 2023 Jul 18;17(7):e01699. doi: 10.1213/XAA.0000000000001699. eCollection 2023 Jul 1.
Differential diagnosis of the underlying cause of new-onset total body paralysis can be challenging and unsatisfying. In akinetic mutism, a rare side effect of tacrolimus, patients become apathetic, mute, and lose voluntary muscle movement. Epidural subarachnoid migration can present with similar symptoms. Delayed emergence/paralysis after anesthesia can include the common culprits of residual operative medications, stroke, as well as tacrolimus-induced akinetic mutism and thoracic epidural migration. We present a case of new-onset total body paralysis, presenting on postoperative day 1 following a double-lung transplant in a patient started on tacrolimus with a thoracic epidural catheter in place.
新发全身瘫痪的根本原因的鉴别诊断具有挑战性且难以令人满意。在他克莫司这一罕见的不良反应肌无力缄默症中，患者会变得冷漠、缄默，并且失去随意肌运动。硬膜外蛛网膜下腔迁移可表现出类似的症状。麻醉后迟发性发作/瘫痪可包括残留手术药物、中风以及他克莫司引起的肌无力缄默症和胸段硬膜外迁移等常见原因。我们报告了一例新发全身瘫痪病例，该患者在接受双肺移植术后 1 天出现这种情况，当时他正在接受他克莫司治疗，同时还放置了胸段硬膜外导管。
