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Longitudinally extensive transverse myelitis after epidural anaesthesia in childbirth

Introduction. Neurological complications related to epidural anesthesia, even
 though rare, must be promptly diagnosed in order to introduce adequate
 therapy in time to prevent further progression of the disorder as well as
 neurological consequences. One of the rare complications of regional
 anesthesia is longitudinal extensive transversal myelitis (LETM) described
 in this paper. Case report. A 32-year old patient, who gave birth by
 Caesarean section in due term, developed LETM the very same day. Considering
 the neuroradiological findings indicating to the long central lesion in the
 thoracic and lumbar spine responding as expected to applied immunotherapy
 (immunosuppressive therapy and therapeutic plasma exchange), it was
 diagnosed of longitudinally extensive transverse myelitis. Even with all the
 therapy and regression of the lesions, patient could not stand up without
 support. Later on in the course of the treatment, according to
 physiatrician`s opinion, physical therapy was ordered, to which patient had
 responded slowly but well, by gradually regaining the function of the lower
 extremities. Conclusion. An early distinction between possible LETM
 etiologies is crucial in providing an accurate prognosis and guiding
 therapeutic strategy.