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Case Reports
. 2023 Jul 18;17(7):e01699.
doi: 10.1213/XAA.0000000000001699. eCollection 2023 Jul 1.

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

Patrick T Hussey  1 , Josiah Sowell  2 , Hanna Hussey  1 , Matthew M Townsley  1
Affiliations
Case Reports

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

Patrick T Hussey et al. A A Pract. .

Abstract

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.

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Conflict of interest statement

The authors declare no conflicts of interest.

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