Acute paraplegia following intrathecal phenol block in the presence of occult epidural malignancy.

A 68-year-old woman with an invading adenocarcinoma of the lung underwent intrathecal phenol block for chest wall pain. Acute paraplegia resulted immediately following the procedure. Subsequent CT scan showed dural compression from an epidural metastasis five segments above the site of the phenol injection. This was confirmed at surgical decompression of the spinal cord and by histological findings. The cause of the paraplegia, which has not recovered, was probably spinal coning.