This case report describes the rare occurrence of tetraplegia, caused by conversion disorder, in a patient who received spinal anesthesia for arthroscopic surgery. A 35-year-old female with a history of migraine headaches received spinal anesthesia for arthroscopic left knee surgery. On sensory block examination, she was noted to have a T10 level of blockade. During surgery and45 min after performing spinal anesthesia, patient reported bilateral loss of both sensation and motor function of her upper limbs. Patient was hemodynamic stable with absence of respiratory depression or any alteration of consciousness level. Physical signs and symptoms did not correlate with any known anatomical or neurological patterns. MRI imaging revealed no abnormalities. Psychiatric consultation was performed wherein familial stressor circumstances were identified, leading to diagnosis of conversion disorder.
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Difficulties or failure in airway management are common factors leading to death and brain damage as a direct result of anesthesia. Prediction of the difficult airway enables the anesthetists to prepare for this challenging clinical scenario. Although the ability to predict accurately a difficult airway preoperatively would be of great value, it is evident from the literature that no single airway assessment can reliably predict a difficult airway. The purpose of this paper is to define the difficult airway and to review the current literature on methods used for prediction of difficult airway.
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