Papers of the Week

While epidural analgesia is generally considered safe in parturients with common spinal cord injuries, little is known about the safety or efficacy of this technique in patients with Brown-Séquard syndrome, a rare disorder consisting of 2% of traumatic spinal cord injuries. We present a case of successfully placing and managing a labor epidural in a patient with Brown-Séquard syndrome who developed a dense block with minimal local anesthetic requirements. To minimize trauma and preserve potentially vulnerable remodeled neural pathways, we recommend cautious, slow epidural medication dosing and use of neuraxial ultrasound rather than landmark-based techniques in these patients.