An acute spinal epidural hematoma after acupuncture combined with dyspnea, dysarthria, bradycardia and hypothermia—a case report

Spinal epidural hemorrhage (EDH) after acupuncture is a rare disease and needs to be differentiated from stroke because it presents neurological deficits such as motor weakness. A 48-year-old patient taking anticoagulants developed posterior neck pain and progressive quadriplegia immediately after acupuncture. Upon arrival to the emergency room (ER), he complained of dyspnea, dysarthria, bradycardia, and hypothermia. Diffuse spinal EDH findings on spinal magnetic resonance imaging (MRI) were confirmed, and posterior decompression was performed emergently. The patient is currently recovering. Since dyspnea, dysarthria, bradycardia, and hypothermia complained of by this patient are not common symptoms of spinal cord injury, emergency medicine doctors should be careful not to miss the spinal cord injury through detailed history-taking and additional neurologic exam.