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Case Reports in Medicine
Volume 2013 (2013), Article ID 751648, 4 pages
http://dx.doi.org/10.1155/2013/751648
Case Report

Caesarean Delivery Complicated by Unintentional Subdural Block and Conversion Disorder

1Anesthesiology Institute and Outcomes Research, Cleveland Clinic Foundation, 9500, Euclid Avenue, Cleveland, Ohio, OH 44195, USA
2Cleveland Clinic Learner College of Medicine of Case Western Reserve University, Cleveland, Ohio, OH 44195, USA
3Anesthesiology Institute, Cleveland Clinic Foundation, 9500, Euclid Avenue, Cleveland, Ohio, OH 44195, USA
4Division of Obstetric Anesthesiology, Hillcrest Hospital, Cleveland Clinic Foundation, 6780, Mayfield Road, Mayfield Heights, Ohio, OH 44124, USA

Received 6 August 2013; Accepted 11 October 2013

Academic Editor: Curtis W. Slipman

Copyright © 2013 Hesham Elsharkawy 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

Combined spinal epidural (CSE) can provide excellent labor analgesia. Subdural block is also a potential but rare complication of attempted epidural placement during a CSE procedure, which may present as a block that is usually patchy in nature, with a component of sensory and/or motor deficit and a variable duration of action. In addition, a conversion disorder or a functional neurological disorder has been described with epidural and spinal anesthesia in obstetric patients. In this clinical report, we describe a 33-year-old G4P3 at 40 weeks gestation that received an unintentional subdural block as part of her labor analgesia and after an uneventful caesarean delivery presented with a conversion disorder. The rarity of the association between a subdural block and a conversion disorder complicated by the fact that the neurological deficit produced by the subdural block and that produced by a conversion disorder are similar in distribution made the clinical presentation and diagnosis a challenge for the obstetric anesthesia team. A functional neurological disorder of this nature complicating a subdural block in an obstetric anesthesia clinical practice has not been described so far.