Post spinal Monoplegia

[yogenbhatt1]

Was called to see one case that was given Spinal previous day for an LSCS. Patient  got the typical electrical shock feel and shooting pain in the leg while the injection was given. 2.2 ml Bupivacain was given at L3-L4 and the surgery got over in about an hour.
At night the patient complained about not being able to move one leg and lack of sensations in that leg.
Next day I was called and on examination there was total lack of  motor, sensory and reflex activity, a picture of complete transaction of cord.
We advised Methyle Prednisolone 500mg and followed by standard Dexamethasone 8mg TDS.
It could not have been a hematoma, as the effect was purely on one leg. It can't be spinal artery damage as it was given at L3 -L4. A small 26 G needle can not cut the cord or the root. We felt that this must be injection in the nerve root leading to focal ischeamia and swelling, compressing roots on that side.
Next day MRI was done. Surprisingly it showed element of demyelination/ mylitis at T11-T12.
Either way, same treatment was continued and the patient showed steady but slow recovery. Muscle power was 70% back in about 6 days. Sensory power had reached till thigh.
Was discharged home next day and still is steadily recovering.
Any further light on this issue?
I am presenting this in my next meet which is tomorrow. Do enlighten me if we were grossly wrong.

[sandiphari]

PRE -SPINAL  PREPERATION  CONTAINING  BETADINE  MIGHT CAUSE  CHEMICAL  IRRITATION.  NOW  PEOPLE  RECCOMMENED   CLORHEXIDINE  SOLU.