A Case Report of Successful Vaginal Delivery for Cauda Equina Syndrome Combined with Complex Regional Pain Syndrome

Hwawon Lim,1 Yumi Shin,1 Hyunjo Kim,2 Bo Young Choi,1 Jee Yoon Park,1,3 Jae-Young Lim,2,4 Pyung-Bok Lee5 1Department of Obstetrics and Gynecology, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 2Department of Rehabilitation Medicine, South Gyeonggi Regional Health & Medical Center for Persons with Disabilities, Seongnam, Republic of Korea; 3Department of Obstetrics and Gynecology, College of Medicine Seoul National University, Seoul, Republic of Korea; 4Department of Rehabilitation Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea; 5Department of Anesthesiology and Pain Medicine, Seoul National University Bundang Hospital, College of Medicine Seoul National University, Seongnam, Republic of KoreaCorrespondence: Jee Yoon Park, Department of Obstetrics and Gynecology Seoul National University Bundang Hospital, 82 Gumi-ro, 173 beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Republic of Korea, Tel +82-31-787-7266, Fax +82-31-787-4054, Email [email protected]: Cauda equina syndrome (CES) is defined as a complex clinical entity associated with simultaneous compression of several or all lumbosacral spine nerve roots. Complex regional pain syndrome (CRPS) is a chronic and non-treatable pain condition resulting in lifetime disability due to a tendency to relapse. Both diseases present with chronic pain and neuropathy. We aimed to report a unique patient with successful pregnancy and delivery although she had both CES and CRPS.Case Presentation: Here we present a female who was diagnosed as CES with CRPS after fall from a high building about 10 years previously. She became pregnant after two miscarriages, maintained her pregnancy with numerous pain killers and finally delivered a healthy baby vaginally. Interestingly, during her parturition, she was tolerable with labor pain unlike her chronic pain that came from CES and CRPS.Conclusion: She is a unique and significant case because of the rare condition that has two pain-associated diseased and success of vaginal delivery without any complication during pregnancy. This case may be helpful in counselling attending physicians and may inspire other pre-existing CES or CRPS patients who are afraid to decide on pregnancy.Keywords: cauda equina syndrome, complex regional pain syndrome, delivery, neuropathy, parturition, pregnancy, CES, CRPS