-Case Reports-

Aggravation of Pre-Existing Cervical Spondylotic Myelopathy with Limb Paralysis Following Lumbar Puncture: A Case Report

Akiko Yamazaki^1,2, Masahiro Mishina³, Masanori Sakamaki¹, Takehiko Nagao¹ and Kazumi Kimura¹

¹Department of Neurology, Nippon Medical School, Tokyo, Japan
²Dementia-Related Disease Medical Centre, Nippon Medical School Musashi Kosugi Hospital, Kanagawa, Japan
³Department of Neurology, Tokyo Rosai Hospital, Tokyo, Japan

This case report highlights a rare occurrence of paraplegia following lumbar puncture (LP) in the presence of cervical disc herniation during cerebrospinal fluid (CSF) drainage. The patient was an elderly woman undergoing investigation for suspected neoplastic meningitis who experienced sudden acute paraplegia on the day following the LP procedure. LP is often contraindicated in patients with intracranial lesions. If patients exhibit myelopathy symptoms, such as increased lower extremity reflexes and positive Hoffmann and Trömner's signs without intracranial lesions, a thorough evaluation for occupying lesions, including cervical spondylotic myelopathy, is recommended before LP is carried out.

J Nippon Med Sch 2025; 92: 435-439

Keywords
lumbar puncture, quadriplegia, cervical spondylosis, myelopathy

Correspondence to
Akiko Yamazaki, Dementia-Related Disease Medical Centre, Nippon Medical School Musashi Kosugi Hospital, 1-383 Kosugi-cho, Nakahara-ku, Kawasaki, Kanagawa 211-8533, Japan
s03-026oa0415@nms.ac.jp

Received, May 8, 2024
Accepted, August 5, 2024