Open AccessAcute Quadriplegia after Lumbar Puncture in a Patient with Misdiagnosed Cervical Myelopathy
Author(s) -
Juwhan Lee,
Sung Hwa Paeng,
Yong Woo Shim,
Won Hee Lee,
Sung Tae Kim,
Se Young Pyo
Publication year - 2020
Publication title -
korean journal of neurotrauma
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.19
H-Index - 3
eISSN - 2288-2243
pISSN - 2234-8999
DOI - 10.13004/kjnt.2020.16.e39
Subject(s) - medicine , myelopathy , lumbar puncture , lumbar , surgery , spinal cord , cerebrospinal fluid , pathology , psychiatry
The incidence of quadriplegia following drainage of cerebrospinal fluid by lumbar puncture (LP) below a spinal occupying lesion is rare. We report a case of acute quadriplegia following LP for presumed normal pressure hydrocephalus (NPH) in a 66-year-old man. Acute cervical myelopathy with a herniated cervical disc was subsequently found on magnetic resonance imaging (MRI) at the C5-6 level. After posterior decompression and anterior cervical discectomy and fusion at the C5-6 level with a cervical plate, the patient's motor and sensory functions recovered. Clinicians should be aware that symptoms of NPH and cervical myelopathy may overlap, and that serious complications may occur when performing LP below a spinal lesion. As a safety measure, cervical spine MRI should be performed before LP.