ABSTRACT
A 15-year-old girl developed severe pain in her right upper limb within a few days after she experienced an astatic epileptic seizure accompanied by falling on her right side. She was treated with fluid infusion through a cannula into her right hand. Swelling, mild flaring, and muscle weakness of the right arm subsequently appeared. Pharmacotherapy and stellate ganglion block were ineffective, and continuous epidural anesthesia was commenced 14 days after the falling event. The pain and accompanying symptoms completely disappeared within 5 days. Early treatment with continuous epidural anesthesia may be a promising option for the management of complex regional pain syndrome during childhood.
Subject(s)
Anesthesia, Epidural/methods , Complex Regional Pain Syndromes/drug therapy , Accidental Falls , Adolescent , Female , Humans , Seizures/complicationsABSTRACT
A 34-year-old woman who was 25 weeks pregnant showed neurological symptoms of bitemporal hemianopsia and vision loss on the left side. MRI study revealed a pituitary tumor requiring surgical removal. We planned cesarean section after 32 weeks of pregnancy and removal of pituitary tumor after the improvement of general conditions of the paturient following cersarean section. However, the above-mentioned neurological symptoms rapidly deteriorated. Therefore, we decided to perform the cesarean section at 30 weeks and 3 days of pregnancy and simultaneous surgical removal of the pituitary tumor. As soon as cesarean section was successfully performed with epidural anesthesia, the pituitary tumor was removed trans-sphenoidally under general anesthesia. Postoperative conditions of the mother and newborn were good and neurological symptoms of the mother improved markedly.
