Caesarean Delivery Complicated by Unintentional Subdural Block and Conversion Disorder

Abstract EN

Combined spinal epidural (CSE) can provide excellent labor analgesia.

Subdural block is also a potential but rare complication of attempted epidural placement during a CSE procedure, which may present as a block that is usually patchy in nature, with a component of sensory and/or motor deficit and a variable duration of action.

In addition, a conversion disorder or a functional neurological disorder has been described with epidural and spinal anesthesia in obstetric patients.

In this clinical report, we describe a 33-year-old G4P3 at 40 weeks gestation that received an unintentional subdural block as part of her labor analgesia and after an uneventful caesarean delivery presented with a conversion disorder.

The rarity of the association between a subdural block and a conversion disorder complicated by the fact that the neurological deficit produced by the subdural block and that produced by a conversion disorder are similar in distribution made the clinical presentation and diagnosis a challenge for the obstetric anesthesia team.

A functional neurological disorder of this nature complicating a subdural block in an obstetric anesthesia clinical practice has not been described so far.