Acute esotropia after epidural anesthesia.

Abstract

Cranial nerve palsy after dural puncture is an uncommon complication. The sixth cranial nerve is the most commonly affected because of its long intracranial course. We report a case of acute comitant esotropia that occurred after unintentional dural puncture. A young woman presented with acute onset comitant esotropia 1 week after epidural anesthesia for a normal vaginal delivery during which the dura was unintentionally punctured. Magnetic resonance imaging revealed diffuse pachymeningeal enhancement, typically seen after dural puncture. Resolution was spontaneous. Puncture of the dura should be considered when acute strabismus is diagnosed shortly after epidural anesthesia.