Transverse myelitis following general and epidural anaesthesia in a paediatric patient

A 13-year-old girl developed transverse myelitis 2 weeks after an uncomplicated, combined general and epidural anaesthetic for orthopaedic surgery. Since epidural anaesthesia had been used, a causal relationship might have been assumed. We review the aetiology and pathogenesis of acute transverse myelitis and the role of anaesthesia in this disorder. Although a causal relationship cannot be assumed and regional anaesthesia in children is considered safe, we would like to re-emphasise the management principles and practices that may improve the benefit-to-risk ratio of these techniques.