Track topics on Twitter Track topics that are important to you
In clinical practice, cervical transforaminal epidural steroid injection (TFESI) is commonly used for alleviating pain. We report a case of segmental spinal myoclonus that developed after cervical transforaminal local anesthetic and steroid injection. A 39-year-old man presented involuntary movements of the bilateral upper trapezius muscles after cervical TFESI on the right C6 and C7 roots with a 5 mg dexamethasone injectate mixed with 0.5 mL of 1% lidocaine and 0.5 mL of normal saline at each level. His myoclonus was semi-rhythmic and continuously persisted at a frequency of approximately 30 episodes per minute. The myoclonus continued even at rest and during sleep. Also, it was resistive to stimulus, such as touch and voluntary action. Based on the clinical features, the patient was diagnosed as having a segmental spinal myoclonus. Clonazepam 0.25 mg was administered three times daily. The myoclonus gradually improved and resolved completely within two weeks. Segmental spinal myoclonus is one of rare complications after cervical TFESI. Clinicians should be aware of the likelihood of this potential complication.
This article was published in the following journal.
Name: American journal of physical medicine & rehabilitation
Digital subtraction imaging (DSI) decreases the risk of intravascular injection during cervical transforaminal epidural steroid injection (CTFESI); however, sequence acquisition and interpretation are...
Despite many clinical trials on cervical epidural steroid injections, the indications for and long-standing outcomes of this treatment remain controversial. We evaluated the outcomes and indications f...
Cervical spinal manipulation therapy is a common non-invasive treatment for neck pain and stiffness, and has been widely used in the population. However, most people do not pay attention to the potent...
Spinal epidural abscess is a rare pathology with an incidence that has tripled in the past two decades. Ventral cervical epidural abscesses (vCEA) of the cervical spine pose particular treatment chall...
Spontaneous cervical epidural hematoma (SCEH) is an uncommon cause of acute spinal cord compression. This is a rare idiopathic condition that leads to acute onset of neurologic deficits, which if not ...
Do cervical epidural steroid injections done by transforaminal catheter targeted approach improve pain and function in patients with cervical radicular pain?
The purpose of this study is to compare the clinical efficacy, incidence of ventral epidural spreading and provocation of concordant paresthesia, amount of radiation exposure and total pro...
Interventional spine procedures are becoming more common. Safety is partly related to proper technique. Injection of steroids and local anesthetics in the vascular space may have serious...
This study evaluates whether there is a correlation between intravascular injection rate and severity of cervical foraminal stenosis during cervical transforaminal epidural steroid injecti...
Chronic lumbosacral radiculopathy secondary to lumbar spinal stenosis affects a large number of individuals, and there is a general lack of consensus in the medical community in terms of e...
A rare epidural hematoma in the spinal epidural space, usually due to a vascular malformation (CENTRAL NERVOUS SYSTEM VASCULAR MALFORMATIONS) or TRAUMA. Spontaneous spinal epidural hematoma is a neurologic emergency due to a rapidly evolving compressive MYELOPATHY.
Circumscribed collections of suppurative material occurring in the spinal or intracranial EPIDURAL SPACE. The majority of epidural abscesses occur in the spinal canal and are associated with OSTEOMYELITIS of a vertebral body; ANALGESIA, EPIDURAL; and other conditions. Clinical manifestations include local and radicular pain, weakness, sensory loss, URINARY INCONTINENCE, and FECAL INCONTINENCE. Cranial epidural abscesses are usually associated with OSTEOMYELITIS of a cranial bone, SINUSITIS, or OTITIS MEDIA. (From Adams et al., Principles of Neurology, 6th ed, p710 and pp1240-1; J Neurol Neurosurg Psychiatry 1998 Aug;65(2):209-12)
A network of nerve fibers originating in the upper four cervical spinal cord segments. The cervical plexus distributes cutaneous nerves to parts of the neck, shoulders, and back of the head, and motor fibers to muscles of the cervical spinal column, infrahyoid muscles, and the diaphragm.
The administration of medication by insertion of a tiny needle or catheter into the spinal sac or epidural cavity.
Neoplasms located in the space between the vertebral PERIOSTEUM and DURA MATER surrounding the SPINAL CORD. Tumors in this location are most often metastatic in origin and may cause neurologic deficits by mass effect on the spinal cord or nerve roots or by interfering with blood supply to the spinal cord.
Pain is a feeling (sharp or dull) triggered in the nervous system which can be transient or constant. Pain can be specific to one area of the body eg back, abdomen or chest or more general all over the body eg muscles ache from the flu. Without pain ...
Anesthesia is the loss of feeling or sensation in all or part of the body. It may result from damage to nerves or can be induced by an anesthetist (a medical professional) using anesthetics such as thiopental or propofol or sevoflurane during a surgical ...
Sleep disorders disrupt sleep during the night, or cause sleepiness during the day, caused by physiological or psychological factors. The common ones include snoring and sleep apnea, insomnia, parasomnias, sleep paralysis, restless legs syndrome, circa...