• C Varela, F Palacio, M A Reina, A López, and J Benito-León.
• Servicio de Anestesiología y Reanimación, Hospital Madrid Montepríncipe, Madrid, Spain.
• Neurologia. 2007 Apr 1;22(3):196-200.

IntroductionThe Horner's syndrome in association with the anesthetic techniques is produced by a blockade of the stellate ganglion sympathetic fibers. This complication is produced by the local anesthetic non-expected migration when it is administered either in the epidural space while performing an epidural block or inside the aponeurosis vascular elements during the performance of a brachial plexus block. Its evolution is quick, with benign incident that disappears in a few hours, without leaving any sequels. It can occur in patients without any previous clinical condition.Clinical CaseWe described the case of 28 years old pregnant woman, with a body mass index of 40.6, without any previous neurological background, who was admitted into hospital for labour. She had epidural analgesia and needed a caesarean section 2 hours later. Twenty minutes after the administration of an epidural dose of local anesthetic, the patient developed a completed left side Horner's Syndrome, as well as ipsi-lateral brachial paresis, that lasted for three hours, with complete recovery.ConclusionsSeveral etiopathologenic options were considered at the time, such as a possible subdural or paravertebral migration of the local anesthetic, the influence of the patient's position (decubitus) and the possible existence of fibrotic compartments in the epidurals space.

40 keywords...

hide…