• Anneleen Herijgers, Lisa Van Dyck, Ilse Leroy, Laurens Dobbels, and Peter B C Van de Putte.
• Anesthesiology, KUL UZ Gasthuisberg, Leuven, Belgium.
• Reg Anesth Pain Med. 2021 Sep 1; 46 (9): 828-830.

BackgroundParaplegia is a rare complication of spinal anesthesia.Case PresentationWe report a case of a 68-year-old man who developed postoperative paraplegia and hypoesthesia after spinal anesthesia for an otherwise uncomplicated transurethral resection of the prostate. Acute transverse myelitis was diagnosed based on urgent MRI. A prior history of similar though less severe neurological symptoms after obinutuzumab treatment for follicular lymphoma suggested a potential causative role for obinutuzumab, a novel monoclonal antibody that has not been associated with such devastating neurological side effects yet. High-dose steroid treatment partially attenuated the symptoms, but debilitating hypoesthesia and motor deficit remained present 3 months postoperatively.ConclusionThe presented case warrants caution when performing neuraxial anesthesia in patients on monoclonal antibody therapies.© American Society of Regional Anesthesia & Pain Medicine 2021. No commercial re-use. See rights and permissions. Published by BMJ.

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