PA Medical News about Migraine Disorders Morphine Neurologic Manifestations Spinal Cord Injections, Spinal

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Central Sensory-Motor Deficit After Uneventful Single-Dose Spinal Morphine Administration in a Patient with Preexisting Migraine Headaches
Anesthesia & Analgesia, 10/21/09

Lentschener C et al. – The authors report a persisting central neurological deficit after single–dose spinal administration of 400 microg of morphine in a patient with no previous neurological condition. Hemiplegic migraine was thought to be present when the patient emerged from anesthesia. Weakness in the left quadriceps and saddle anesthesia of the perineum and urinary retention of central origin remained present 3 yr later. Over the 3 postoperative years, the patient was admitted to a neurological unit 5 times because of acute headache associated with complete left–sided hemiplegia. These symptoms resolved within 24 h of onset. Hemiplegic migraine was thought to be the most likely diagnosis of these recurrent attacks. The authors hypothesize that the patient’s persistent deficits were caused by a combination of spinal morphine and spinal cord vascular dysfunction associated with hemiplegic migraine.