Epileptic crisis and headache after a lumbar epidural steroid injection

España Fuente, L.

doi:10.1016/j.redare.2020.07.005

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Different slices showing pneumocephalus. Multiple air collections in basal cisterns, in bilateral frontal parasagittal, right temporal and intraventricular sulci, in both frontal horns, and in the right temporal horn (arrows)." ] ] ] "textoCompleto" => "We report the case of a 74-year-old man who was referred to the Pain Unit when he presented right sided sciatica refractory to usual medical treatment, due to a right subarticular hernia involving the origin of the right S1 nerve root. With the patient seated, the epidural space was located with the loss of resistance to air technique, and 10 mg of dexamethasone (2 mL), 0.5% bupivacaine (2 mL) and saline to make a total volume of 6 mL was administered. After 10 min, the patient reported sudden onset of severe oppressive headache accompanied by dizziness, facial paraesthesia, and a very short seizure episode from which he recovered. We immediately performed urgent cranial computed tomography (CT), which showed pneumocephalus (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The electroencephalogram and cranial magnetic resonance angiography were normal.<elsevierMultimedia ident="fig0005"></elsevierMultimedia>Given the seriousness of symptoms our patient presented, it is essential to carry out a differential diagnosis with other aetiologies, such as intracranial haemorrhage, subarachnoid haemorrhage, cervical artery dissection, cerebral venous thrombosis or a reversible cerebral vasoconstriction syndrome." "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2020-06-04" "fechaAceptado" => "2020-07-01" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: España Fuente L. Crisis epiléptica y cefalea tras infiltración epidural lumbar con corticoides. Rev Esp Anestesiol Reanim. 2020;67:570–571." ] ] "multimedia" => array:1 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1160 "Ancho" => 2175 "Tamanyo" => 144511 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0005" "detalle" => "Figure " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "Cranial CT. Different slices showing pneumocephalus. 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ISSN: 2341-1929

Revista Española de Anestesiología y Reanimación (REDAR) -the Spanish Journal of Anesthesiology and Resuscitation- is the scientific body of the Spanish Society of Anesthesiology, Resuscitation and Pain Therapy. This is a monthly journal (10 issues) that publishes scientific articles of all areas within its specialty: clinical anesthesia, resuscitation-intensive medicine and critical care, diagnosis and treatment of acute and chronic pain, urgent care and emergencies and studies on basic science and related fields. The journal accepts work in both Spanish and English.

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0.9

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1.8

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0.239

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362

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