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Tsai ST, Huang WS, Jiang SK, Liao HY. Cervical spinal epidural abscess following needle-knife acupotomy, with an initial presentation that mimicked an acute stroke: A case report. HONG KONG J EMERG ME 2020; 27:99-102. [DOI: 10.1177/1024907918790858] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023] Open
Abstract
Introduction: A spinal epidural abscess is difficult to diagnose and it can sometimes mimic an acute ischemic stroke.Case presentation: We report a 69-year-old woman attended our emergency department because of gross hematuria for 1 week, with fever and bilateral flank pain. Two weeks earlier, she had received needle-knife acupotomy (a more invasive procedure than the traditional acupuncture) for chronic neck pain. Acute pyelonephritis was diagnosed; however, 4 h later, she developed weakness of both right limbs. Acute lacunar infarction was tentatively diagnosed. After admission, weakness of the left limbs developed, with a feeling of fullness and discomfort around the entire T6 dermatome with urinary retention. Neck magnetic resonance imaging showed extensive cervical epidural abscesses from C3 to T1. After an operation, her neck pain and the weakness of the four limbs gradually improved.Discussion: Spinal epidural abscess is a rare complication, and which should be considered for patients who have undergone invasive cervical procedures. Needle-knife acupotomy is a more invasive procedure than the traditional acupuncture. Conclusion: Although it is considered safe and effective for cervical spondylosis, it can be complicated by spinal infection. Careful disinfection should therefore be performed, and disposable needleknives should be used.
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Affiliation(s)
- Sheng-Ta Tsai
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan (R.O.C.)
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan (R.O.C.)
| | - Wei-Shih Huang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan (R.O.C.)
| | - Shin-Kuang Jiang
- Department of Neurology, China Medical University Hospital, Taichung, Taiwan (R.O.C.)
| | - Hsien-Yin Liao
- Graduate Institute of Acupuncture Science, China Medical University, Taichung, Taiwan (R.O.C.)
- Department of Acupuncture, China Medical University Hospital, Taichung, Taiwan (R.O.C.)
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