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Case Reports in Anesthesiology
Volume 2012 (2012), Article ID 732584, 3 pages
http://dx.doi.org/10.1155/2012/732584
Case Report

Unilateral Hemiparesis with Thoracic Epidural in an Adolescent

1Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA 02115, USA
2Division of Pediatric Anesthesiology, Department of Anesthesiology, University of Illinois Medical Center, 1740 West Taylor Street, Chicago, IL 60612, USA

Received 6 December 2011; Accepted 18 January 2012

Academic Editors: I.-O. Lee, P. Michalek, and S. Ogawa

Copyright © 2012 Rosalie F. Tassone et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Unilateral sensory and motor blockade is known to occur with epidural anesthesia but is rarely reported in children. The differential diagnosis should include the presence of a midline epidural septum. Case Report. We describe a case of a 16-year-old adolescent who developed repeated complete unilateral extensive epidural sensory and motor blockade with Horner’s syndrome after thoracic epidural catheter placement. This unusual presentation of complete hemibody neural blockade has not been reported in the pediatric population. Maneuvers to improve contralateral uniform neural blockade were unsuccessful. An epidurogram was performed to ascertain the correct location of the catheter within the epidural space and presence of sagittal compartmentalization. Conclusion. This case report highlights a less frequently reported reason for unilateral sensory and motor blockade with epidural anesthesia in children. The presence of a midline epidural septum should be considered in the differential diagnosis of unilateral epidural blockade.