Intrathecal Digoxin Administration During Spinal Anesthesia: A Case Report Outlining Recovery and Rehabilitation

Cureus, 2024 · DOI: 10.7759/cureus.65376 · Published: July 25, 2024

Simple Explanation

A young woman accidently received an injection of Digoxin, a heart medication, directly into her spine during a C-section. This caused serious complications including brain inflammation, hearing loss, and paralysis. However, with intensive rehabilitation, she showed significant recovery in cognition and mobility, eventually walking with assistance.

Study Duration

1 Month

Participants

24-year-old female

Evidence Level

Case Report

Key Findings

1
The patient demonstrated significant improvement in both cognition and functional mobility during a one-month inpatient rehabilitation program.
2
The patient's ISNSCI exam improved from T5 AIS C to T10 AIS D, indicating significant neurological recovery.
3
The patient experienced subjective recovery of hearing loss, scoring within normal limits on auditory screening examination prior to discharge.

Research Summary

This case report highlights the rehabilitation outcomes of a 24-year-old female who received inadvertent intrathecal digoxin during a routine cesarean section, leading to encephalomeningitis, vestibulocochlear neuritis, and incomplete paraplegia. Despite initial neurological deficits, the patient demonstrated significant improvement in both cognition and functional mobility during a one-month inpatient rehabilitation program, ultimately achieving ambulation with assistive devices. This case underscores the potential for rehabilitation of neurological sequela following accidental intrathecal digoxin administration.

Practical Implications

Rehabilitation Feasibility

Rehabilitation is feasible and can lead to significant improvements in neurological function following intrathecal digoxin administration.

Multidisciplinary Approach

A multidisciplinary rehabilitation approach is crucial in managing patients who sustain complex neurological injuries from such incidents.

Prevention Strategies

Healthcare facilities should implement safeguards to prevent accidental intrathecal digoxin administration, such as separating digoxin and bupivacaine vials.

Study Limitations

1
The study is limited to a single case report, which may not be generalizable to all patients.
2
Formal audiologic testing was not performed to fully assess the extent of hearing recovery.
3
Long-term follow-up data beyond the outpatient rehabilitation program is not available.

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