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Acute-Onset Quadriparesis After Placement of Thoracic Epidural

A Case Report

Gonzalez, Meera N., MD; Sethi, Anish, DO; McGavin, Jason, MD; Trehan, Gaurav, MD

doi: 10.1213/XAA.0000000000000867
Case Reports

Blunt chest trauma and the treatment of associated pain can lead to impaired respiratory drive and abnormal pulmonary mechanics, in turn resulting in significant respiratory system complications. These can include pneumonia, hypoxia, atelectasis, and a prolonged need for invasive mechanical ventilation. Epidural analgesia can decrease the need for systemic pain control and may improve cooperation with pulmonary rehabilitation exercises. However, this treatment modality also carries a small risk of severe neurological complications such as spinal cord trauma, spinal cord ischemia, and epidural hematoma or abscess. This case report describes one such rare neurological complication: acute quadriparesis after thoracic epidural placement.

From the Department of Anesthesiology, Lewis Katz School of Medicine at Temple University, Philadelphia, Pennsylvania.

Accepted for publication July 9, 2018.

Funding: None.

The authors declare no conflicts of interest.

Address correspondence to Meera N. Gonzalez, MD, Department of Anesthesiology, Lewis Katz School of Medicine at Temple University, 3rd Floor, 3401 N Broad St, Philadelphia, PA 19140. Address e-mail to

© 2019 International Anesthesia Research Society
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