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November 3, 1945


JAMA. 1945;129(10):664-667. doi:10.1001/jama.1945.02860440012004

The literature has many reports of sequelae involving the nervous system after spinal anesthesia. These have been disturbances in sensation, stiff neck, cranial nerve involvement (second, third, fourth, sixth, seventh, eighth and twelfth), impaired bladder and rectal function, hemiplegia and paraplegia, pyramidal tract degeneration, meningoencephalitis, polioencephalitis, myelitis, myelopathy, radiculitis, severe "neuritis," septic and aseptic meningitis, arachnoiditis, cauda equina neuritis and others.1

Falk2 reported headacheand stiff neck lasting several days in about 6 per cent of persons after spinal anesthesia. This he regarded not as a complication but as a normal result of spinal anesthesia. More seriously, meningitis has been often reported after spinal anesthesia.3 In 8 cases of so-called aseptic meningitis there were three deaths;4 the others were "benign" and recovered. In that series, symptoms began sixty hours after the anesthetic had entered the subarachnoid space. There was an increase of lymphocytes in the spinal fluid