The patient is a 38-years-old female primigravid at 40-41 weeks age of gestation who was referred for labor analgesia. Physical examination was unremarkable. She however had optic neuritis two years prior to admission which which gave her residual blurring of vision on her left eye. she was given lumbar epidural analgesia using bupivacaine 0.1%and 50 mg fentanyl. The fetus however had non-reassuring fetal heart tones thus the decision to do cesarean section. Epidural anesthesianwas given via the indwelling epidural catheter using Bupivcaine 0.5%. The operation and recovery were unremrkable up to postoprative daw 4 when the patient experienced low back pain followed by motor and sensory deficit from the umbilicus down. The complication of lumbar epidural anesthesia was first entertained was first entertained further investigaion revealed that the patient has multiple sclerosis.
Human ; Female ; Adult ; ANESTHESIA, EPIDURAL ; MYELITIS, TRANSVERSE ; OPTIC NEURITIS ; MULTIPLE SCLEROSIS ; ANESTHESIA, LOCAL ; ANALGESIA, EPIDURAL ; MULTIPLE SCLERO ; GRAVIDITY