Tacrolimus-Induced Akinetic Mutism or Epidural Catheter Migration: A Case Report.

Differential diagnosis of the underlying cause of new-onset total body paralysis can be challenging and unsatisfying. In akinetic mutism, a rare side effect of tacrolimus, patients become apathetic, mute, and lose voluntary muscle movement. Epidural subarachnoid migration can present with similar symptoms. Delayed emergence/paralysis after anesthesia can include the common culprits of residual operative medications, stroke, as well as tacrolimus-induced akinetic mutism and thoracic epidural migration. We present a case of new-onset total body paralysis, presenting on postoperative day 1 following a double-lung transplant in a patient started on tacrolimus with a thoracic epidural catheter in place. Copyright © 2023 International Anesthesia Research Society.

Citation

Patrick T Hussey, Josiah Sowell, Hanna Hussey, Matthew M Townsley. Tacrolimus-Induced Akinetic Mutism or Epidural Catheter Migration: A Case Report. A&A practice. 2023 Jul 01;17(7):e01699

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PMID: 37463290

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