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August 22, 2026Anesthesia and Pain MedicineOpen Access

Novel Use of Electromyography Guidance for Epidural Blood Patch Injection in a Comatose Patient due to Severe Spontaneous Intracranial Hypotension - A case report -

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Authors

APAntonio PereiraEKElizabeth KasparovDWDominique Williams

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Overview

Case report demonstrates successful electromyography-guided epidural blood patch in a comatose patient with spontaneous intracranial hypotension, indicating a safe approach when verbal feedback is...

Key Points

  • To evaluate the feasibility and safety of utilizing electromyography guidance during an epidural blood patch procedure in a comatose patient unable to provide subjective feedback.
  • Treated a 40-year-old male with severe spontaneous intracranial hypotension who developed cognitive decline progressing to coma despite standard medical and surgical management (N=1).
  • Performed an epidural blood patch using concurrent fluoroscopy and electromyography (EMG) monitoring as an objective surrogate for neural safety and procedural efficacy.
  • EMG monitoring enabled real-time procedural safety assessment in the absence of verbal communication.
  • The patient achieved progressive neurological recovery and clinical improvement following the EMG-assisted epidural blood patch.

Cite This Study

Pereira et al. (2026) studied this question.

synapsesocial.com/papers/6a895f53ca7ade938187decfhttps://doi.org/10.17085/apm.26524
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