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Case report.
A previously well 34-year-old woman sought treatment postpartum for left leg weakness. Several hours after labor onset, pain was noticed in the left groin and medial thigh. Epidural anesthesia was commenced via the L3/L4 interspace. The pain resolved within 15 minutes. A deep transverse arrest occurred, and semi-urgent cesarean section was performed without complication. Difficulty in left leg adduction was apparent the following day with walking requiring assistance. Bladder, bowel, and contralateral leg function were normal.
Examination revealed profound weakness of left thigh adduction only. Knee and ankle reflexes were normal bilaterally with flexor plantar responses. The left adductor reflex was significantly reduced, whereas the right was easily elicited. A small area of decreased pinprick sensation was present over the medial left thigh. MRI of the lumbosacral spine was performed 5 days postpartum with no evidence of lumbar nerve root compression.
Three weeks later, significant weakness of left thigh adduction remained. The adductor reflex was more …
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