Probable cervical midline epidural septum complicating the treatment of a patient with upper extremity sympathetically maintained pain

摘要: Abstract We present a woman who developed left arm sympathetically maintained pain (SMP, or "shoulder-hand syndrome") as result of brachial plexus injury. After confirmatory diagnosis with both stellate local anesthetic block and intravenous phentolamine infusion, the patient had cervical epidural catheter placed infusion started. numerous unilateral blocks were obtained, epidurogram demonstrated probable midline septum. Catheter placement was adjusted, successful chemical sympathectomy performed for 6 days. This resulted in significant relief patient's shoulder well almost complete resolution SMP symptoms. case represents, to our knowledge, first documentation use secondary pathology at site proximal that symptomatology, presumptive