Oculomotor paralysis and spinal anesthesia

We describe a case of a parturient scheduled for Caesarean section in whom diplopia from abducens (sixth cranial) nerve palsy followed spinal anaesthesia performed with a 25 gauge Whitacre needle. After delivery, the patient experienced neckache, diplopia and postural headache successively. These symptoms were related to the dural puncture. Despite two consecutive epidural blood patches, no improvement of diplopia was observed. In 8 months, the nerve palsy had completely resolved.