Transient Hypokalemic Quadriplegia Following a Lumbar Transforaminal Epidural Dexamethasone Injection: A Case Report

A 30-year-old male with no significant past medical history presented with hypokalemic quadriplegia four hours after he received a lumbar transforaminal epidural steroid injection (TFESI) containing dexamethasone and lidocaine. A comprehensive work up ruled out acquired and hereditary causes of hypokalemic paralysis. Symptoms gradually resolved within hours after potassium restoration with no residual neurologic deficits. Paralysis after TFESI is uncommon, but has been associated with particulate steroids that can coalesce into aggregates and occlude vessels.

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