BROWN-SÉQUARD PARALYSIS FOLLOWING A PARAVERTEBRAL ALCOHOL INJECTION FOR ANGINA PECTORIS

Abstract

The paravertebral injection method for the treatment of angina pectoris has been made popular by the individual writings of Mandl, Swetlow and White. The object of the method is to inject the sympathetic chain along the upper thoracic vertebrae with procaine hydrochloride or alcohol or with both. The treatment is based on the theory that the pain of angina pectoris is transmitted through the rami communicantes to the spinal nerve roots and thence to the brain, and that the greater part of these painful sensations travel through the upper thoracic roots. A search of the literature has failed to reveal a complication similar to the one that we are reporting. Although the method of paravertebral injection may appear simple, our case proves that occasionally an unfortunate complication may result, even when performed by an expert. Fluoroscopic examination during the injection would be ideal, and under such conditions unlucky events would