A Case Report of Successful Vaginal Delivery for Cauda Equina Syndrome Combined with Complex Regional Pain Syndrome.

Abstract

Background: Cauda equina syndrome (CES) is defined as a complex clinical entity associated with simultaneous compression of several or all lumbosacral spine nerve roots. Complex regional pain syndrome (CRPS) is a chronic and non-treatable pain condition resulting in lifetime disability due to a tendency to relapse. Both diseases present with chronic pain and neuropathy. We aimed to report a unique patient with successful pregnancy and delivery although she had both CES and CRPS.

Case presentation: Here we present a female who was diagnosed as CES with CRPS after fall from a high building about 10 years previously. She became pregnant after two miscarriages, maintained her pregnancy with numerous pain killers and finally delivered a healthy baby vaginally. Interestingly, during her parturition, she was tolerable with labor pain unlike her chronic pain that came from CES and CRPS.

Conclusion: She is a unique and significant case because of the rare condition that has two pain-associated diseased and success of vaginal delivery without any complication during pregnancy. This case may be helpful in counselling attending physicians and may inspire other pre-existing CES or CRPS patients who are afraid to decide on pregnancy.