<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1727-897X</journal-id>
<journal-title><![CDATA[MediSur]]></journal-title>
<abbrev-journal-title><![CDATA[Medisur]]></abbrev-journal-title>
<issn>1727-897X</issn>
<publisher>
<publisher-name><![CDATA[Universidad de Ciencias Médicas de Cienfuegos, Centro Provincial de Ciencias Médicas, Provincia de Cienfuegos.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1727-897X2021000200274</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Encefalomielitis tóxica por anestesia espinal. Presentación de un caso]]></article-title>
<article-title xml:lang="en"><![CDATA[Toxic encefphalomyelitis due to spinal anesthesia. Presentation of a case]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Puentes]]></surname>
<given-names><![CDATA[Dayana Arce]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cano]]></surname>
<given-names><![CDATA[Roberto G. Albín]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Docente Clínico Quirúrgico Freyre de Andrade  ]]></institution>
<addr-line><![CDATA[ ]]></addr-line>
<country>Cuba</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2021</year>
</pub-date>
<volume>19</volume>
<numero>2</numero>
<fpage>274</fpage>
<lpage>279</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_arttext&amp;pid=S1727-897X2021000200274&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_abstract&amp;pid=S1727-897X2021000200274&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.sld.cu/scielo.php?script=sci_pdf&amp;pid=S1727-897X2021000200274&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN:  Introducción:  Las complicaciones neurológicas como consecuencia de anestesia espinal se han reportado frecuentemente debido al amplio uso de dicha anestesia, la cual puede ocasionar una mielopatía tóxica.  Presentación del Caso  Paciente de 26 de edad con antecedentes de salud, fue ingresada en el Hospital Clínico Quirúrgico Freyre de Andrade 24 horas después de operada por hemorroides con anestesia espinal (lidocaína hiperbárica). Comienza con ptosis palpebral derecha y dificultad para la marcha. Es egresada y dos días después ingresa en obnubilación y rigidez de nuca con LCR (Líquido Cefalorraquídeo) - positivo y sospecha de meningoencefalitis. Evoluciona en coma sin respuesta satisfactoria a antibióticos durante 14 días. Se constata edema cerebral, trastornos autonómicos, hemiparesia alterna y paraplejía fláccida. Se retira antibiótico y se trata con betametasona parenteral durante dos meses más fisioterapia durante 10 meses. Tuvo mejoría progresiva y recuperación casi total. Todos los estudios microbiológicos fueron normales en suero y líquido cefalorraquídeo  Discusión:  Se han reportado disímiles lesiones neurológicas por anestesia espinal que incluyen 3 síndromes: meningoencefalitis, lesión de pares craneales y paraparesia(plejía). El caso que presentamos presentó los 3 tipos de lesiones más edema cerebral.  Conclusiones: Es infrecuente la asociación de los tres síndromes pues no encontramos caso igual en bases de datos. La resolución con betametasona es un aspecto terapéutico a considerar ante casos similares.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract:  Introduction:  Neurological complications as a consequence of spinal anesthesia have been frequently reported due to its extensive use, which can cause toxic myelopathy.  Case Presentation  A 26-years-old patient with a health history was admitted to the Freyre de Andrade Clinical Surgical Hospital 24 hours after surgery for hemorrhoids with spinal anesthesia (hyperbaric lidocaine). It begins with right palpebral ptosis and difficulty walking. She was discharged and two days later she was admitted with drowsiness and stiff neck with positive CSF and suspected meningoencephalitis. She evolves into a coma with no satisfactory response to antibiotics for 14 days. Cerebral edema, autonomic disorders, alternating hemiparesis, and flaccid paraplegia are noted. The antibiotic was withdrawn and she was treated with parenteral betamethasone for two months plus physiotherapy for 10 months. She had progressive improvement and almost total recovery. All serum and cerebrospinal fluid microbiological studies were normal.  Discussion:  Dissimilar neurological injuries have been reported by spinal anesthesia that include 3 syndromes: meningoencephalitis, cranial nerve injury and paraparesis (plegia). This case had 3 types of lesions plus cerebral edema.  Conclusions:  The association of the three syndromes is infrequent since we did not find the same case in databases. Resolution with betamethasone is a therapeutic aspect to consider in similar cases]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[encefalomielitis]]></kwd>
<kwd lng="es"><![CDATA[anestesia raquídea]]></kwd>
<kwd lng="es"><![CDATA[informes de casos]]></kwd>
<kwd lng="en"><![CDATA[encephalomyelitis]]></kwd>
<kwd lng="en"><![CDATA[anestesia;spinal]]></kwd>
<kwd lng="en"><![CDATA[case reports]]></kwd>
</kwd-group>
</article-meta>
</front><back>
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