Contralateral limb weakness after intrathecal chemical neurolysis for cancer pain

Abstract

The treatment of cancer pain encompasses both pharmacological and interventional techniques. In certain situations, patients may have intractable pain despite use of optimal doses of oral or parenteral analgesics. Interventional procedures, like intrathecal chemical neurolysis (ICN), play an important role in the management of such intractable cancer pains. The goal is to achieve segmental block that is purely sensory, without causing any motor weakness in the patient. Potential problems related to ICN include inadequate pain control with the progression of tumour size, short duration of effect, lower limb weakness on the ipsilateral side and rectal or bladder sphincter dysfunction. We present a case report in which the patient developed unexpected weakness of contralateral limb after ICN for management of cancer pain.