Table 4

Spinal fluid and imaging findings reported with adverse reactions from epidural injections. Methylprednisolone acetate (40 mg–200 mg (Depo-Medrol sterile aqueous suspension—Pharmacia and Upjohn))

DiagnosisI Spinal fluid studies
Protein (mg/dl)Glucose (mg/dl)White cells (mm3)CulturesComments
Arachnoiditis from chemical meningitis302411300 polysNegativeMRI intensities in meninges, recovery after steroid therapy
Chemical meningitis775488000 polysNegative“Dural tear,” recovery after prophylactic antibiotics
Chemical meningitis420898400 (type unknown)NegativeEvent followed third epidural injection, patient recovered, prophylactic antibiotics given
Meningitis, unknown aetiology400501700 lymphsUnknownTreated for TBC meningitis 6 weeks after epidural therapy
II Imaging results
Diagnosis Imaging procedures Results Comments
Myelopathy and arachnoiditisMyelogram with CTAdhesive arachnoiditisOrganic mental syndrome
Arachnoiditis from chemical meningitisCT brainCT: pneumocephalusCT performed day of injection
MRI brainMRI: meningeal enhancementMRI performed 1 and 4 weeks post injection
“Encephalopathy”CT brainPneumocephalusCT performed day of procedure, spinal fluid results not reported
“Encephalopathy”CT brainPneumocephalusHeadache and dysarthria, recovered
  • Polys=Polymorphonuclear leucocytes; lymphs=lymphocytes.